Journal of Nippon Medical School
Online ISSN : 1347-3409
Print ISSN : 1345-4676
ISSN-L : 1345-4676
Originals
Intraoperative Low-Field Magnetic Resonance Imaging-Guided Tumor Resection in Glioma Surgery: Pros and Cons
Yu FujiiToshihiro OgiwaraGen WatanabeYoshiki HanaokaTetsuya GotoKazuhiro HongoTetsuyoshi Horiuchi
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JOURNAL FREE ACCESS

2022 Volume 89 Issue 3 Pages 269-276

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Abstract

Background: Intraoperative magnetic resonance imaging (MRI) is useful for identifying residual tumors during surgery. It can improve the resection rate; however, complications related to prolonged operating time may be increased. We assessed the advantages and disadvantages of using low-field intraoperative MRI and compared them with non-use of iMRI during glioma surgery. Methods: The study included 22 consecutive patients who underwent total tumor resection at Shinshu University Hospital between September 2017 and October 2020. Patients were divided into two groups (before and after introducing 0.4-T low-field open intraoperative MRI at the hospital). Patient demographics, gross total resection (GTR) rate, postoperative neurological deficits, need for reoperation, and operating time were compared between the groups. Results: No significant differences were observed in patient demographics. While GTR of the tumor was achieved in 8/11 cases (73%) with intraoperative MRI, 2/11 cases (18%) of the control group achieved GTR (p=0.033). Seven patients had transient neurological deficits: 3 in the intraoperative MRI group and 4 in the control group, without significant differences between groups. There was no unintended reoperation in the intraoperative MRI group, except for one case in the control group. Mean operating time (465.8 vs. 483.6 minutes for the intraoperative MRI and control groups, respectively) did not differ. Conclusions: Low-field intraoperative MRI improves the GTR rate and reduces unintentional reoperation incidence compared to the conventional technique. Our findings showed no operating time prolongation in the MRI group despite intraoperative imaging, which considered that intraoperative MRI helped reduce decision-making time and procedural hesitation during surgery.

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© 2022 by the Medical Association of Nippon Medical School
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