Clinical Evaluation and Follow-up Results for Intraoperative Magnetic Resonance Imaging in Neurosurgery

Abstract

Intraoperative MRI is safe and allows reliable updating of neuronavigational data, with compensation for brain shifting. Surgically induced imaging changes, which have been identified as a possible problem with intraoperative MRI in general, necessitated comparisons with preoperative scans and require future attention. The extent of tumor removal and survival times were increased significantly. Overall, patients seemed to benefit from the method.

Survival rates in patients with low‐grade glioma after intraoperative magnetic resonance image guidance

“…Several other groups have utilized MRI readings to examine the association between extent of glioma resection and survival, although most included only high-grade lesions, or included a mix of high-grade and low-grade lesions, or were limited in sample size. 18,20 Although the risk estimates in our study suggest a relation between the extent of surgical resection and survival (i.e., 1 in 56 patients died in the gross total resection group vs. 8 in 100 patients died in the subtotal resection group), our results were not statistically significant. A number of explanations are possible for this finding.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Current primary treatment options include surgical resection and/or radiotherapy, although definitive evidence for an optimal treatment remains elusive. Advances in molecular epidemiology indicate that certain histologic subtypes of low-grade gliomas, such as oligodendrogliomas, may have varied response to chemother- apeutic agents based on chromosomal changes, including loss of chromosome 1p and/or 19q, and, hence, may have improved survival with use of these agents.…”

“…Despite the many projects [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] that have examined the association between both the use and the extent of surgical resection with outcomes for neurosurgical patients who are diagnosed with low-grade gliomas, 3 the relation remains unclear. In addition, although previous studies have examined the role of intraoperative magnetic resonance imaging (MRI) in tumor volume measurement, 18,20 the reports that exist generally are relatively small in size, present estimates that were not adjusted for age and/or histology, vary by study patient composition, or present study results in nonstandard statistical format. No study to date has utilized measurements of tumor volume and resection obtained using intraoperative (MRI) to calculate age-adjusted and histology-adjusted estimates of recurrence and survival rates (with associated standard errors) for patients with low-grade glioma.…”

Innovative Surgical Management of Glioma

“…In 2000, Wirtz and colleagues examined 68 cases of high grade glioma resected with iMRI 16 . Of the 68 cases, 27% of showed GTR on the first iMRI scan and 66% percent underwent continued resection.…”

Computer-assisted 3D ultrasound-guided neurosurgery: technological contributions, including multimodal registration and advanced display, demonstrating future perspectives

“…Surgical tools may be tracked by positioning systems and the surgeon may navigate the tools into the brain based on image information only (1)(2)(3). Intraoperative imaging has been shown to be important for obtaining improved resection and increased survival time for the patient undergoing surgery (4,5). The available navigation systems differ somewhat in software, positioning systems and visualization features but most of the commercial systems still have practical limitations, due to lack of integration with intraoperative imaging to provide the surgeon with updated image information.…”