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Usefulness of intraoperative magnetic resonance imaging for glioma surgery

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Medical Technologies in Neurosurgery

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 98))

Summary

Background. Radical resection of gliomas can increase patient’ s survival. There is known concern, however, that aggressive tumour removal can result in neurological morbidity. The objective of the present study was to evaluate the usefulness of low magnetic field strength (0.3 Tesla) open intraoperative magnetic resonance imaging (iMRI) for complete resection of glioma with emphasis on functional outcome.

Methods. From 2000 to 2004, 96 patients with intracranial gliomas underwent tumour resection with the use of iMRI in Tokyo Women ’s Medical University. There were 50 men and 46 women; mean age was 39 years. Tumour volume varied from 1.2 ml to 198 ml (median: 36.5 mL). Resection rate and postoperative neurological status were compared between control group (46 cases, operated on during the initial period after installation of iMRI), and study group (50 most recent cases, in whom surgery was done using established treatment algorithm and improved image quality).

Findings. Overall, mean resection rate was 93%, and medial residual tumour volume was 0.17 ml. Total tumour removal was achieved in 44 cases (46%). Compared to control group, resection rate in the study group was significantly higher (91% vs. 95%; P < 0.05), whereas residual tumour volume was significantly smaller (1.7 mL vs. 0.025 mL; P < 0.001). Nine patients in the control group (20%) and 24 in the study group (48%) experienced temporary postoperative neurological deterioration (P < 0.01), however, the rate of permanent morbidity evaluated 3 months after surgery did not differ significantly between the groups investigated (13% vs. 14%).

Conclusions. Use of iMRI during surgery for intracranial gliomas permits to attain aggressive tumour resection with good functional outcome. Nevertheless, surgical experience with the iMRI system, establishment of treatment algorithm, and improvement of image quality are of paramount importance for optimal results.

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References

  1. Albert FK, Forsting M, Sartor K, Adams HP, Kunze S (1994) Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 34: 45–60

    Article  PubMed  CAS  Google Scholar 

  2. Berger MS, Deliganis AV, Dobbins J, Keles GE (1994) The effect of extent of resection on recurrence in patients with low grade cerebral hemisphere gliomas. Cancer 74: 1784–1791

    Article  PubMed  CAS  Google Scholar 

  3. Black PM, Moriarty T, Alexander E, Stieg P, Woodard EJ, Gleason PL, Martin CH, Kikinis R, Schwartz RB, Jolesz FA (1997) Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery 41: 831–842

    Article  PubMed  CAS  Google Scholar 

  4. Brell M, Ibanez J, Caral L, Ferrer E (2000) Factors influencing surgical complications of intra-axial brain tumours. Acta Neurochir (Wien) 142: 739–750

    Article  CAS  Google Scholar 

  5. Britton JW, Cascino GD, Sharbrough FW, Kelly PJ (1994) Low-grade glial neoplasms and intractable partial epilepsy: efficacy of surgical treatment. Epilepsia 35: 1130–1135

    Article  PubMed  CAS  Google Scholar 

  6. Ciric I, Rovin R, Cozzens JW, Eller TW, Vick NA, Mikhael MA (1990) Role of surgery in the treatment of malignant cerebral gliomas. Presented at Association of Neurological Surgeons, Park Ridge, IL

    Google Scholar 

  7. Curran WJ, Scott CB, Horton J, Nelson JS, Weinstein AS, Nelson DF, Fischbach AJ, Chang CH, Rotman M, Asbell SO (1992) Does extent of surgery influence outcome for astrocytoma with atypical or anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group (RTOG) trials. J Neurooncol 12: 219–227

    Article  PubMed  Google Scholar 

  8. Devaux BC, O’Fallon JR, Kelly PJ (1993) Resection, biopsy, and survival in malignant glial neoplasms. A retrospective study of clinical parameters, therapy, and outcome. J Neurosurg 78: 767–775

    PubMed  CAS  Google Scholar 

  9. Fransson A, Andreo P, Potter R (2001) Aspects of MR image distortions in radiotherapy treatment planning. Strahlenther Onkol 177: 59–73

    Article  PubMed  CAS  Google Scholar 

  10. Gasser T, Ganslandt O, Sandalcioglu E, Stolke D, Fahlbusch R, Nimsky C (2005) Intraoperative functional MRI: implementation and preliminary experience. Neuroimage 26: 685–693

    Article  PubMed  Google Scholar 

  11. Hadani M, Spiegelman R, Feldman Z, Berkenstadt H, Ram Z (2001) Novel, compact, intraoperative magnetic resonance imaging-guided system for conventional neurosurgical operating rooms. Neurosurgery 48: 799–807

    Article  PubMed  CAS  Google Scholar 

  12. Hess KR (1999) Extent of resection as a prognostic variable in the treatment of gliomas. J Neurooncol 42: 227–231

    Article  PubMed  CAS  Google Scholar 

  13. Iseki H, Muragaki Y, Taira T, Kawamata T, Maruyama T, Naemura K, Nambu K, Sugiura M, Hirai N, Hori T, Takakura K (2001) New possibilities for stereotaxis. Information-guided stereotaxis. Stereotact Funct Neurosurg 76: 159–167

    Article  PubMed  CAS  Google Scholar 

  14. Kelly PJ, Hunt C (1994) The limited value of cytoreductive surgery in elderly patients with malignant gliomas. Neurosurgery 34: 62–66

    Article  PubMed  CAS  Google Scholar 

  15. Kiwit JC, Floeth FW, Bock WJ (1996) Survival in malignant glioma: analysis of prognostic factors with special regard to cytoreductive surgery. Zentralblatt fur Neurochirurgie 57: 76–88

    PubMed  CAS  Google Scholar 

  16. Kreth FW, Warnke PC, Scheremet R, Ostertag CB (1993) Surgical resection and radiation therapy versus biopsy and radiation therapy in the treatment of glioblastoma multiforme. J Neurosurg 762–726

    Google Scholar 

  17. Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, De-Monte F, Lang FF, McCutcheon IE, Hassenbusch SJ, Holland E, Hess K, Michael C, Miller D, Sawaya R (2001) A multivariate analysis of 416_patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95: 190–198

    Article  PubMed  CAS  Google Scholar 

  18. Muragaki Y, Iseki H, Kawamata T, Sugiura M, Amano K, Taira T, Hori T, Nambu K, Suzukawa K (2000) Development of “real-time ” navigation system updated with intraoperative MRimaging for total removal of glioma.Funct Neurosurg (Japanese) 39: 80–81

    Google Scholar 

  19. Nimsky C, Ganslandt O, Cerny S, Hastreiter P, Greiner G, Fahlbusch R (2000) Quantification of, visualization, and compensation for brain shift using intraoperative magnetic resonance imaging. Neurosurgery 47: 1070–1080

    Article  PubMed  CAS  Google Scholar 

  20. Nimsky C, Ganslandt O, Hastreiter P, Wang R, Benner T, Sorensen AG, Fahlbusch R (2005) Intraoperative diffusion-tensor MR imaging: shifting of white matter tracts during neurosurgical procedures-initial experience. Radiology 234: 218–225

    Article  PubMed  Google Scholar 

  21. Nimsky C, Ganslandt O, Von Keller B, Romstock J, Fahlbusch R (2004) Intraoperative high-field-strength MR imaging: implementation and experience in 200_patients. Radiology 233: 67–78

    Article  PubMed  Google Scholar 

  22. Ozawa N, Muragaki Y, Shirakawa K, Suzukawa K, Nakamura R, Watanabe H, Iseki H, Takakura K (2004) Development of navigation system employing intra-operative diffusion weighted imaging using open MRI. In: Lemke HU, Vannier MW, Inamura A, Farman AG, Doi K, Reiber HC eds CARS 2004 Computer assisted radiology and surgery. Elsevier, Amsterdam, pp 679–702

    Google Scholar 

  23. Prados MD, Gutin PH, Phillips TL, Wara WM, Larson DA, Sneed PK, Davis RL, Ahn DK, Lamborn K, Wilson CB (1992) Highly anaplastic astrocytoma: a review of 357_patients treated between 1977 and 1989. Int J Radiat Oncol Biol Phys 23: 3–8

    PubMed  CAS  Google Scholar 

  24. Rubino GJ, Farahani K, McGill D, Van De Wiele B, Villablanca JP, Wang-Mathieson A (2000) Magnetic resonance imaging-guided neurosurgery in the magnetic fringe fields: the next step in neuronavigation. Neurosurgery 46: 643–653

    Article  PubMed  CAS  Google Scholar 

  25. Sawaya R (1999) Extent of resection in malignant gliomas: a critical summary. J Neurooncol 42: 303–305

    Article  PubMed  CAS  Google Scholar 

  26. Sawaya R, Hammoud M, Schoppa D, Hess KR, Wu SZ, Shi WM, Wildrick DM (1998) Neurosurgical outcomes in a modern series of 400_craniotomies for treatment of parenchymal tumors. Neurosurgery 42: 1044–1055

    Article  PubMed  CAS  Google Scholar 

  27. Scerrati M, Roselli R, Iacoangeli M, Pompucci A, Rossi GF (1996) Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: the role of surgery. J Neurol Neurosurg Psychiatry 61: 291–296

    PubMed  CAS  Google Scholar 

  28. Shi WM, Wildrick DM, Sawaya R (1998) Volumetric measurement of brain tumors from MR imaging. J Neurooncol 37: 87–93

    Article  PubMed  CAS  Google Scholar 

  29. Steinmeier R, Fahlbusch R, Ganslandt O, Nimsky C, Buchfelder M, Kaus M, Heigl T, Lenz G, Kuth R, Hu kW (1998) Intraoperative magnetic resonance imaging with the magnetom open scanner: concepts, neurosurgical indications, and procedures: a preliminary report. Neurosurgery 43: 739–747

    Article  PubMed  CAS  Google Scholar 

  30. Sutherland GR, Louw DF (1999) Intraoperative MRI: a moving magnet. CMAJ 161: 1293

    PubMed  CAS  Google Scholar 

  31. The Committee of Brain Tumor Registry of Japan (2000) Report of brain tumor registry of Japan 1969–1993 10th edition. Neurol Med Chir (Tokyo) [Suppl] 40: 1–106

    Article  Google Scholar 

  32. Tronnier VM, Wirtz CR, Knauth M, Lenz G, Pastyr O, Bonsanto MM, Albert FK, Kuth R, Staubert A, Schlegel W, Sartor K, Kunze S (1997) Intraoperative diagnostic and interventional magnetic resonance imaging in neurosurgery. Neurosurgery 40: 891–900

    Article  PubMed  CAS  Google Scholar 

  33. Vecht CJ, Avezaat CJJ, van Putten WLJ, Eijkenboom WMH, Stefanko SZ (1990) The influence of the extent of surgery on the neurologic function and suvival in malignant glioma. A retrospective analysis in 243_patients. J Neurol Neurosurg Psychiatry 53: 466–471

    CAS  Google Scholar 

  34. Vives KP, Piepmeier JM (1999) Complications and expected outcome of glioma surgery. J Neurooncol 42: 289–302

    Article  PubMed  CAS  Google Scholar 

  35. Wirtz CR, Knauth M, Staubert A, Bonsanto MM, Sartor K, Kunze S, Tronnier VM (2000) Clinical evaluation and followup results for intraoperative magnetic resonance imaging in neurosurgery. Neurosurgery 46: 1112–1120

    Article  PubMed  CAS  Google Scholar 

  36. Wirtz CR, Tronnier VM, Bonsanto MM, Knauth M, Staubert A, Albert FK, Kunze S (1997) Image-guided neurosurgery with intraoperative MRI: update of frameless stereotaxy and radicality control. Stereotact Funct Neurosurg 68: 39–43

    Article  PubMed  CAS  Google Scholar 

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Muragaki, Y. et al. (2006). Usefulness of intraoperative magnetic resonance imaging for glioma surgery. In: Nimsky, C., Fahlbusch, R. (eds) Medical Technologies in Neurosurgery. Acta Neurochirurgica Supplements, vol 98. Springer, Vienna. https://doi.org/10.1007/978-3-211-33303-7_10

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  • DOI: https://doi.org/10.1007/978-3-211-33303-7_10

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33302-0

  • Online ISBN: 978-3-211-33303-7

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