Edward Fomekong1, Thierry Duprez2, Marie-Agnès Docquier3, Glennie Ntsambi1, Dominique Maiter4, Christian Raftopoulos5. 1. Department of Neurosurgery, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. 2. Department of Radiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. 3. Department of Anesthesiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. 4. Department of Internal Medicine, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. 5. Department of Neurosurgery, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. Electronic address: christian.raftopoulos@uclouvain.be.
Abstract
OBJECTIVE: To report a single-center experience with a 3T intraoperative magnetic resonance imaging (iMRI) to assess transsphenoidal microsurgery on pituitary macroadenomas. METHODS: In a dual, independent operating room (OR) magnetic resonance imaging (MRI) suite, the operating table with the anesthetized patient was moved on rail tracks once a supposed maximized resection was reached to the MRI room for intraoperative image acquisition and interpretation. After the assessment of the iMRI images, the neurosurgeon evaluated whether additional resection was still possible. The resection rates were assessed on iMRI and postoperative MRI at 3 months. RESULTS: A total of 73 macroadenomas benefited from an iMRI from March 2006 to October 2011. The gross total resection (GTR) rate at the time of the first iMRI was 58.9% (n=43). Based on the iMRI, eight patients (10.9%) underwent a second surgical resection. In 3 cases, the intraoperative imaging results were suspicious for a minor residue but not convincing enough for further surgery. Fortunately, the 3 months postoperative MRI control did not disclose any residual tumor in these cases. Finally, the GTR rate at the 3-month postoperative MRI increased to 72.6% (n=53). CONCLUSIONS: 3T intraoperative MRI offered excellent quality images. Its use during transsphenoidal microsurgery on pituitary macroadenomas led to an increase not only in the extent of tumor resection (in 8 patients) but also in the rate of radical resections (69% instead of 60%). No complications due to the iMRI procedure were observed.
OBJECTIVE: To report a single-center experience with a 3T intraoperative magnetic resonance imaging (iMRI) to assess transsphenoidal microsurgery on pituitary macroadenomas. METHODS: In a dual, independent operating room (OR) magnetic resonance imaging (MRI) suite, the operating table with the anesthetized patient was moved on rail tracks once a supposed maximized resection was reached to the MRI room for intraoperative image acquisition and interpretation. After the assessment of the iMRI images, the neurosurgeon evaluated whether additional resection was still possible. The resection rates were assessed on iMRI and postoperative MRI at 3 months. RESULTS: A total of 73 macroadenomas benefited from an iMRI from March 2006 to October 2011. The gross total resection (GTR) rate at the time of the first iMRI was 58.9% (n=43). Based on the iMRI, eight patients (10.9%) underwent a second surgical resection. In 3 cases, the intraoperative imaging results were suspicious for a minor residue but not convincing enough for further surgery. Fortunately, the 3 months postoperative MRI control did not disclose any residual tumor in these cases. Finally, the GTR rate at the 3-month postoperative MRI increased to 72.6% (n=53). CONCLUSIONS: 3T intraoperative MRI offered excellent quality images. Its use during transsphenoidal microsurgery on pituitary macroadenomas led to an increase not only in the extent of tumor resection (in 8 patients) but also in the rate of radical resections (69% instead of 60%). No complications due to the iMRI procedure were observed.
Authors: Reem D Almutairi; Ivo S Muskens; David J Cote; Mark D Dijkman; Vasileios K Kavouridis; Erin Crocker; Kholoud Ghazawi; Marike L D Broekman; Timothy R Smith; Rania A Mekary; Hasan A Zaidi Journal: Acta Neurochir (Wien) Date: 2018-01-06 Impact factor: 2.216
Authors: Alexander Micko; Fabian Placzek; Roger Fonollà; Michael Winklehner; Ryan Sentosa; Arno Krause; Greisa Vila; Romana Höftberger; Marco Andreana; Wolfgang Drexler; Rainer A Leitgeb; Angelika Unterhuber; Stefan Wolfsberger Journal: Front Endocrinol (Lausanne) Date: 2021-10-18 Impact factor: 5.555