Intra-operative 3.0 T Magnetic Resonance Imaging Using a Dual-Independent Room: Long-Term Evaluation of Time-Cost, Problems, and Learning-Curve Effect

Abstract

We present a short and comprehensive report of our 39-month experience using a 3.0 T intra-operative magnetic resonance imaging (ioMRI) neurosurgical-MR twin room, including a description of the problems encountered and the associated time-delays. Forty-seven problems were experienced during the 189 ioMRI procedures (two ioMRI were performed in five of the 184 surgical procedures) performed in the 39-month period, including a blocked transfer table, failure of anesthetic monitoring material, and specific MRI-related problems, such as head and coil positioning difficulties, artefacts, coil malfunctions and other technical difficulties. None of these problems prevented the ioMRI procedure from taking place or affected image interpretation, but they sometimes caused a significant delay. Fifteen (32%) of these problems occurred during the initial learning curve period. The mean duration of the ioMRI procedure was 75 min, which decreased slightly with experience, although an average waiting-for-access time of 24 min could not be avoided. These results illustrate that although performing ioMRI at 3.0 T with the dual room is a challenging procedure, it remains safe and feasible and associated with only minor dysfunctions while offering optimal image quality and standard surgical conditions.

Glioblastoma surgery with and without intraoperative MRI at 3.0T

“…The extent of resection (EOR), which can be improved by ioMRI, is significantly linked to the survival duration of patients suffering from GBM [8,11,[13][14][15]. Despite this substantial advantage, the impact of ioMRI on surgery in terms of costs and time loss has also been highlighted by several authors [14,18,[25][26][27][28][29].…”

Intraoperative MRI without an intraoperative MRI suite: a workflow for glial tumor surgery

“…Other studies have found that the use of high field iMRI prolonged the operation time between 72 and 120 min. [ 4 , 12 , 13 , 21 ] However, when our results are compared to older studies, it must be acknowledged that we benefit from the development of faster MRI scanning techniques. Relying on a single MRI scanner for iMRI, however, may introduce significant delays in the process.…”

“…Relying on a single MRI scanner for iMRI, however, may introduce significant delays in the process. A study by Martin et al, found that problems with the MRI scanner leading to longer operation times occurred in as much as a fourth of the patients [ 13 ]. These problems are rarely present when the patient is moved to a radiology ward where several scanners are available.…”

Usefulness of Intraoperative Computed Tomography in Complication Management after Spine Surgery

“…Intraoperative MRI suites surely provide the best visualization of the spinal cord structures, but it resembles a quite expensive and time-consuming modality. 13 Furthermore, the method has its limitations after ACDF-procedures because of artifacts of implanted cages, especially in operations with additional anterior plating. Also, intraoperative ultrasound is deviously limited in visualizing structures dorsal the vertebral bodies; it may provide information about the spinal cord after amplified ventral exposure via corpectomy, but especially in degenerative spinal cord compression with ossified posterior longitudinal ligament, it has limited utility due to artifacts from residual ossification and limitation by the bony exposure.…”