Intraoperative use of low-field magnetic resonance imaging for brain tumors: A systematic review

Abstract

Background: Low-field magnetic resonance imaging (LF-MRI) has become a valuable tool in the diagnosis of brain tumors due to its high spatial resolution and ability to acquire images in a short amount of time. However, the use of LF-MRI for intraoperative imaging during brain tumor surgeries has not been extensively studied. The aim of this systematic review is to investigate the impact of low-field intraoperative magnetic resonance imaging (LF-IMRI) on the duration of brain tumor surgery and the extent of tumor resection. Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar from February 2000 to December 2022. The studies were selected based on the inclusion criteria and reviewed independently by two reviewers. The gathered information was organized and analyzed using Excel. Results: Our review of 21 articles found that low-field intraoperative MRI (LF-IMRI) with a field below 0.3T was used in most of the studies, specifically 15 studies used 0.15T LF-IMRI. The T1-weighted sequence was the most frequently reported, and the average scanning time was 24.26 min. The majority of the studies reported a positive impact of LF-IMRI on the extent of tumor resection, with an increase ranging from 11% to 52.5%. Notably, there were no studies describing the use of ultra-low-field (ULF) intraoperative MRI. Conclusion: The results of this systematic review will aid neurosurgeons and neuroradiologists in making informed decisions about the use of LF-MRI in brain tumor surgeries. Further, research is needed to fully understand the impact of LF-MRI in brain tumor surgeries and to optimize its use in the clinical setting. There is an opportunity to study the utility of ULF-MRI in brain tumor surgeries.

Low-field MRI for use in neurological diseases

“…Low-field MRI also has strong potential for intraoperative imaging during brain tumour surgeries, thanks to low risk of device interactions, heating, metallic projectiles and reduced noise (in addition to lower cost and power consumption). A recent systematic review [39] yielded 21 articles for low-field intraoperative MRI with magnetic fields between 0.15 T and 0.3 T. The majority of studies reported a positive impact of low-field intraoperative MRI on the extent of tumour resection, with reduced complications and better survival. These advantages did, however, come at the expense of a longer surgical duration.…”