OBJECTIVE: To determine the impact of intraoperative magnetic resonance imaging (iMRI) on the decision to proceed with additional glioma resection during surgery and to maximize extent of resection (EOR). METHODS: Patients who underwent craniotomy for glioma resection with high-field iMRI guidance were prospectively evaluated between September 2006 and August 2007. Volumetric analysis and EOR were assessed with iMRI, using postcontrast T1-weighted images for tumors showing contrast enhancement and T2-weighted images for nonenhancing tumors. RESULTS: Forty-six patients underwent resection using iMRI guidance, with iMRI being used to evaluate the EOR in 44 patients and for reregistration in 2 patients. Surgery was terminated after iMRI in 23 patients (52%) because gross total resection was achieved or because of residual tumor infiltration in an eloquent brain region. Twenty-one patients (47%) underwent additional resection of residual tumor after iMRI. For enhancing gliomas, the median EOR increased significantly from 84% (range, 59%-97%) to 99% (range, 85%-100%) with additional tumor removal after iMRI (P < 0.001). For nonenhancing gliomas, the median EOR increased (from 63% to 80%) with additional tumor removal after iMRI, but not significantly, owing to the small sample size (7 patients). Overall, the EOR increased from 76% (range, 35%-97%) to 96% (range, 48%-100%) (P < 0.001). Gross total resection was achieved after additional tumor removal after iMRI in 15 of 21 patients (71%). Overall, 29 patients (65%) experienced gross total resection, and in 15 (52%), this was achieved with the contribution of iMRI. CONCLUSION: High-field iMRI is a safe and reliable technique, and its use optimizes the extent of glioma resection.
OBJECTIVE: To determine the impact of intraoperative magnetic resonance imaging (iMRI) on the decision to proceed with additional glioma resection during surgery and to maximize extent of resection (EOR). METHODS:Patients who underwent craniotomy for glioma resection with high-field iMRI guidance were prospectively evaluated between September 2006 and August 2007. Volumetric analysis and EOR were assessed with iMRI, using postcontrast T1-weighted images for tumors showing contrast enhancement and T2-weighted images for nonenhancing tumors. RESULTS: Forty-six patients underwent resection using iMRI guidance, with iMRI being used to evaluate the EOR in 44 patients and for reregistration in 2 patients. Surgery was terminated after iMRI in 23 patients (52%) because gross total resection was achieved or because of residual tumor infiltration in an eloquent brain region. Twenty-one patients (47%) underwent additional resection of residual tumor after iMRI. For enhancing gliomas, the median EOR increased significantly from 84% (range, 59%-97%) to 99% (range, 85%-100%) with additional tumor removal after iMRI (P < 0.001). For nonenhancing gliomas, the median EOR increased (from 63% to 80%) with additional tumor removal after iMRI, but not significantly, owing to the small sample size (7 patients). Overall, the EOR increased from 76% (range, 35%-97%) to 96% (range, 48%-100%) (P < 0.001). Gross total resection was achieved after additional tumor removal after iMRI in 15 of 21 patients (71%). Overall, 29 patients (65%) experienced gross total resection, and in 15 (52%), this was achieved with the contribution of iMRI. CONCLUSION: High-field iMRI is a safe and reliable technique, and its use optimizes the extent of glioma resection.
Authors: Laurence Mercier; Rolando F Del Maestro; Kevin Petrecca; Anna Kochanowska; Simon Drouin; Charles X B Yan; Andrew L Janke; Sean Jy-Shyang Chen; D Louis Collins Journal: Int J Comput Assist Radiol Surg Date: 2010-10-01 Impact factor: 2.924
Authors: Laurence Mercier; Vladimir Fonov; Claire Haegelen; Rolando F Del Maestro; Kevin Petrecca; D Louis Collins Journal: Int J Comput Assist Radiol Surg Date: 2011-06-02 Impact factor: 2.924
Authors: Bassel Zebian; Francesco Vergani; José Pedro Lavrador; Soumya Mukherjee; William John Kitchen; Vita Stagno; Christos Chamilos; Benedetta Pettorini; Conor Mallucci Journal: CNS Oncol Date: 2016-12-21
Authors: Adam M Sonabend; Brad E Zacharia; Michael B Cloney; Aarón Sonabend; Christopher Showers; Victoria Ebiana; Matthew Nazarian; Kristin R Swanson; Anne Baldock; Henry Brem; Jeffrey N Bruce; William Butler; Daniel P Cahill; Bob Carter; Daniel A Orringer; David W Roberts; Oren Sagher; Nader Sanai; Theodore H Schwartz; Daniel L Silbergeld; Michael B Sisti; Reid C Thompson; Allen E Waziri; Zoher Ghogawala; Guy McKhann Journal: Neurosurgery Date: 2017-04-01 Impact factor: 4.654