Intraoperative Diagnostic and Interventional MRI in Neurosurgery: First Experience with an “Open MR” System

Albert, Friedrich K.; Wirtz, Christian Rainer; Tronnier, V.; Hamer, J.; Bonsanto, Mario M.; Staubert, Andreas; Knauth, Michael; Kunze, Stefan

doi:10.1007/978-3-642-58731-3_39

Cited by 4 publications

(25 citation statements)

References 9 publications

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“…They conducted early postoperative CT scanning in 73 patients with high-grade gliomas in which residual tumor at the resection site was demonstrated by contrast enhancement in 41 patients (56.2%); MR imaging was performed in only 35 patients, with early postoperative nonlinear contrast enhancement observed in 24 patients (68.6%). In contrast, transcranial sonography revealed a nonlinear hyperechogenic area in 95.9% of their cases, with a volume that exceeded on average the CT-detected volume by 4.4 cm 2 and MR imaging-detected volume by 3.3 cm 2 . The survival rate of patients in whom no enhancement was demonstrated on postoperative MR imaging correlated with significantly longer survival.…”

Section: Neurosurg Focus / Volume 10 / February 2001mentioning

confidence: 80%

“…Knowledge of these changes is crucial in determining the amount of brain tumor to be resected, which is one of the key factors of postoperative progression-free interval and survival. Recently, intraoperative MR imaging was introduced by our group and others 2,7,15,16,[20][21][22][23][24][25][26][27] to solve some of the aforementioned problems. Although excellent in discriminating a lesion from the surrounding brain by the presence of tissue contrast, MR imaging is a bulky device, interfering with many surgical instruments, including the operating microscope and many electronic systems in the operating room.…”

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confidence: 99%

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Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions

Tronnier¹,

Bonsanto²,

Staubert³

et al. 2001

FOC

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Object The authors undertook a study to compare two intraoperative imaging modalities, low-field magnetic resonance (MR) imaging and a prototype of a three-dimensional (3D)–navigated ultrasonography in terms of imaging quality in lesion detection and intraoperative resection control. Methods Low-field MR imaging was used for intraoperative resection control and update of navigational data in 101 patients with supratentorial gliomas. Thirty-five patients with different lesions underwent surgery in which the prototype of a 3D-navigated ultrasonography system was used. A prospective comparative study of both intraoperative imaging modalities was initiated with the first seven cases presented here. In 35 patients (70%) in whom ultrasonography was performed, accurate tumor delineation was demonstrated prior to tumor resection. In the remaining 30% comparison of preoperative MR imaging data and ultrasonography data allowed sufficient anatomical localization to be achieved. Detection of metastases and high-grade gliomas and intra-operative delineation of tumor remnants were comparable between both imaging modalities. In one case of a low-grade glioma better visibility was achieved with ultrasonography. However, intraoperative findings after resection were still difficult to interpret with ultrasonography alone most likely due to the beginning of a learning curve. Conclusions Based on these preliminary results, intraoperative MR imaging remains superior to intraoperative ultrasonography in terms of resection control in glioma surgery. Nevertheless, the different features (different planes of slices, any-plane slicing, and creation of a 3D volume and matching of images) of this new ultrasonography system make this tool a very attractive alternative. The intended study of both imaging modalities will hopefully allow a comparison regarding sensitivity and specificity of intraoperative tumor remnant detection, as well as cost effectiveness.

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Section: Neurosurg Focus / Volume 10 / February 2001mentioning

confidence: 80%

mentioning

confidence: 99%

Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions

Tronnier¹,

Bonsanto²,

Staubert³

et al. 2001

FOC

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“…(1) has a diameter of 6 or 8 French and can be introduced into the working channel of conventional neuroendoscopes. At the tip of the catheter is a mini-sonoprobe (2). The catheter is inserted in a sterile plastic sheath that has been filled with water (not saline).…”

Section: Imaging Geometrymentioning

confidence: 99%

“…The endoscopically visible landmarks for penetration are the mammillary bodies, the tuber cinereum, and the infundibular recess. In a translucent membranous cinereum (premammillary membrane), the dorsum of the sella (2), which presents a small cyst (3). The caudate nuclei (4) and third ventricle formed by the thalamus (5) are on both sides.…”

Section: Ventral Cisternsmentioning

confidence: 99%

“…Further development, therefore, was aimed at making neuroendoscopy safer. The current concept used to establish a near real-time guidance system has involved the use of magnetic resonance (MR) or computed tomography (CT), requiring enormous financial investment and technical effort (2,6,13,18,20,25,32,65). It is still not clear what surgical benefit this approach of navigation and intraoperative imaging will have (24,33,40,57).…”

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confidence: 99%

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Endoneurosonography

Resch¹,

Schroeder²

2007

Operative Neurosurgery

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Maximizing safe resections: the roles of 5-aminolevulinic acid and intraoperative MR imaging in glioma surgery—review of the literature

2017

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Malignant glioma surgery involves the challenge of preserving the neurological status of patients harboring these lesions while pursuing a maximal tumor resection, which is correlated with overall and progression-free survival. Presently, several tools exist for assisting neurosurgeons in visualizing malignant tissue. Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) has increasingly been used during the last decade for identifying malignant glioma. Intraoperative magnetic resonance imaging (iMRI), first introduced in the mid-1990s, is being evaluated as a further tool to maximize the extent of resection. We aimed to evaluate the literature and discuss synergies and differences between FGS with 5-ALA and iMRI. We conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. After excluding nonrelevant articles, 16 articles were evaluated and included in the qualitative analysis, comprising 2 (n = 2) reviews of the literatures, 1 (n = 1) book chapter, and 13 (n = 13) clinical articles. ALA-induced fluorescence goes beyond the borders of gadolinium contrast enhancement. Several studies stress the synergy between both tools, enabling increase in extent of resection. We point out advantages of combining both methods. iMRI, however, is not widely available, is expensive, and is not recommended as sole resection control tool in high-grade glioma. For these centers, FGS together with mapping and monitoring techniques, neuronavigation and, when needed, intraoperative ultrasound provides an excellent setting for achieving state-of-the-art gross total resection of high-grade gliomas.

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Intraoperative Diagnostic and Interventional MRI in Neurosurgery: First Experience with an “Open MR” System

Cited by 4 publications

References 9 publications

Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions

Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions

Endoneurosonography

Maximizing safe resections: the roles of 5-aminolevulinic acid and intraoperative MR imaging in glioma surgery—review of the literature

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