Thomas F Barrett1, Hadrien A Dyvorne2, Francesco Padormo2, Puneet S Pawha3, Bradley N Delman3, Raj K Shrivastava4, Priti Balchandani2. 1. Department of Neurosurgery, Mount Sinai Medical Center, New York, NY, USA. Electronic address: Thomas.barrett@icahn.mssm.edu. 2. The Translational and Molecular Imaging Institute, Mount Sinai Medical Center, New York, NY, USA. 3. Department of Radiology, Mount Sinai Medical Center, New York, NY, USA. 4. Department of Neurosurgery, Mount Sinai Medical Center, New York, NY, USA.
Abstract
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care. METHODS: Images were acquired at 7 T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5-, 3-, and 7-T scans for detection of intracavernous cranial nerves and internal carotid artery (ICA) branches. Detection rates were compared. Images were used for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. RESULTS: Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7 T. The 7-T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. CONCLUSIONS: Our study represents the first application of 7-T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7-T MRI compared with 3- and 1.5-T MRI, and found that integration of 7 T into surgical planning and guidance was feasible. These results suggest a potential for 7-T MRI to reduce surgical complications. Future studies comparing standardized 7-, 3-, and 1.5-T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7-T MRI for endonasal endoscopic surgical efficacy.
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care. METHODS: Images were acquired at 7 T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5-, 3-, and 7-T scans for detection of intracavernous cranial nerves and internal carotid artery (ICA) branches. Detection rates were compared. Images were used for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. RESULTS: Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7 T. The 7-T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. CONCLUSIONS: Our study represents the first application of 7-T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7-T MRI compared with 3- and 1.5-T MRI, and found that integration of 7 T into surgical planning and guidance was feasible. These results suggest a potential for 7-T MRI to reduce surgical complications. Future studies comparing standardized 7-, 3-, and 1.5-T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7-T MRI for endonasal endoscopic surgical efficacy.
Authors: A E Grams; O Kraff; J Kalkmann; S Orzada; S Maderwald; M E Ladd; M Forsting; E R Gizewski Journal: Clin Neuroradiol Date: 2012-09-27 Impact factor: 3.649
Authors: Oliver Kraff; Anja Fischer; Armin M Nagel; Christoph Mönninghoff; Mark E Ladd Journal: J Magn Reson Imaging Date: 2014-01-30 Impact factor: 4.813
Authors: Alexandra A J de Rotte; Anja G van der Kolk; Dik Rutgers; Pierre M J Zelissen; Fredy Visser; Peter R Luijten; Jeroen Hendrikse Journal: Eur Radiol Date: 2014-05-29 Impact factor: 5.315
Authors: Paul A Gardner; Amin B Kassam; Carl H Snyderman; Ricardo L Carrau; Arlan H Mintz; Steven Grahovac; Susan Stefko Journal: J Neurosurg Date: 2008-07 Impact factor: 5.115
Authors: Charles H Cho; Garni Barkhoudarian; Liangge Hsu; Wenya Linda Bi; Amir A Zamani; Edward R Laws Journal: J Neurosurg Date: 2013-09-13 Impact factor: 5.115
Authors: R Blankena; R Kleinloog; B H Verweij; P van Ooij; B Ten Haken; P R Luijten; G J E Rinkel; J J M Zwanenburg Journal: AJNR Am J Neuroradiol Date: 2016-02-18 Impact factor: 3.825
Authors: John W Rutland; David Goldrich; Joshua Loewenstern; Amir Banihashemi; William Shuman; Sonam Sharma; Priti Balchandani; Joshua B Bederson; Alfred M Iloreta; Raj K Shrivastava Journal: J Neurol Surg B Skull Base Date: 2020-08-05
Authors: John W Rutland; Bradley N Delman; Rebecca E Feldman; Nadejda Tsankova; Hung-Mo Lin; Francesco Padormo; Raj K Shrivastava; Priti Balchandani Journal: J Neurol Surg B Skull Base Date: 2019-11-21
Authors: Korbinian Eckstein; Beata Bachrata; Gilbert Hangel; Georg Widhalm; Christian Enzinger; Markus Barth; Siegfried Trattnig; Simon Daniel Robinson Journal: Neuroimage Date: 2021-05-15 Impact factor: 7.400