Summary
Intraoperative high-field magnetic resonance (MR) imaging with integrated microscope-based navigation is at present one of the most sophisticated technical methods providing a reliable immediate intraoperative quality control. It enables intraoperative imaging at high quality that is up to the standard of up to date pre- and postoperative neuroradiological routine diagnostics. The major indications are pituitary tumor surgery and glioma surgery. In pituitary tumor surgery intraoperative MRI helps to localize hidden tumor remnants that would be otherwise overlooked. The same is true for glioma surgery, where the optimal extent of resection by simultaneous preservation of functional integrity can be achieved. This is possible since high-field MR imaging offers various modalities beyond standard anatomical imaging, such as MR spectroscopy, diffusion tensor imaging, and functional MR imaging which may also be applied intraoperatively, providing not only data on the extent of resection and localization of tumor remnants but also on metabolic changes, tumor invasion, and localization of functional eloquent cortical and deep-seated brain areas.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Albayrak B, Samdani AF, Black PM (2004) Intra-operative magnetic resonance imaging in neurosurgery. Acta Neurochir (Wien) 146: 543–557
Albert FK, Forsting M, Sartor K et al (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: 45–61
Black PM, Alexander III E, Martin C et al (1999) Craniotomy for tumor treatment in an intraoperative magnetic resonance imaging unit. Neurosurgery 45: 423–433
Bohinski RJ, Kokkino AK, Warnick RE et al (2001) Glioma resection in a shared-resource magnetic resonance operating room after optimal image-guided frameless stereotactic resection. Neurosurgery 48: 731–744
Bohinski RJ, Warnick RE, Gaskill-Shipley MF et al (2001) Intraoperative magnetic resonance imaging to determine the extent of resection of pituitary macroadenomas during transsphenoidal microsurgery. Neurosurgery 49: 1133–1144
Bradley WG (2002) Achieving gross total resection of brain tumors: intraoperative MR imaging can make a big difference. AJNR Am J Neuroradiol 23: 348–349
Brown PD, Maurer MJ, Rummans TA et al (2005) A prospective study of quality of life in adults with newly diagnosed highgrade gliomas: the impact of the extent of resection on quality of life and survival. Neurosurgery 57: 495–504
Bucci MK, Maity A, Janss AJ et al (2004) Near complete surgical resection predicts a favorable outcome in pediatric patients with nonbrainstem, malignant gliomas: results from a single center in the magnetic resonance imaging era. Cancer 101: 817–824
Clark CA, Barrick TR, Murphy MM et al (2003) White matter fiber tracking in patients with space-occupying lesions of the brain: a new technique for neurosurgical planning? Neuroimage 20: 1601–1608
Claus EB, Horlacher A, Hsu L et al (2005) Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance. Cancer 103: 1227–1233
Coenen VA, Krings T, Mayfrank L et al (2001) Threedimensional visualization of the pyramidal tract in a neuronavigation system during brain tumor surgery: first experiences and technical note. Neurosurgery 49: 86–93
Fahlbusch R, Ganslandt O, Buchfelder M et al (2001) Intraoperative magnetic resonance imaging during transsphenoidal surgery. J Neurosurg 95: 381–390
Fahlbusch R, Keller B, Ganslandt O et al (2005) Transsphenoidal surgery in acromegaly investigated by intraoperative high-field magnetic resonance imaging. Eur J Endocrinol 153: 239–248
Ganslandt O, Fahlbusch R, Nimsky C et al (1999) Functional neuronavigation with magnetoencephalography: outcome in 50 patients with lesions around the motor cortex. J Neurosurg 91: 73–79
Ganslandt O, Stadlbauer A, Fahlbusch R et al (2005) Proton magnetic resonance spectroscopic imaging integrated into image-guided surgery: correlation to standard magnetic resonance imaging and tumor cell density. Neurosurgery 56: 291–298
Gasser T, Ganslandt O, Sandalcioglu E et al (2005) Intraoperative functional MRI: implementation and preliminary experience.Neuroimage 26: 685–693
Hall WA, Liu H, Martin AJ et al (2000) Safety, efficacy, and functionality of high-field strength interventional magnetic resonance imaging for neurosurgery. Neurosurgery 46: 632–642
Hendler T, Pianka P, Sigal M et al (2003) Delineating gray and white matter involvement in brain lesions: three-dimensional alignment of functional magnetic resonance and diffusion-tensor imaging. J Neurosurg 99: 1018–1027
Henson JW, Gaviani P, Gonzalez RG (2005) MRI in treatment of adult gliomas. Lancet Oncol 6: 167–175
Hentschel SJ, Sawaya R (2003) Optimizing outcomes with maximal surgical resection of malignant gliomas. Cancer Control 10: 109–114
Hirschberg H, Samset E, Hol PK et al (2005) Impact of intraoperative MRI on the surgical results for high-grade gliomas. Minim Invasive Neurosurg 48: 77–84
Kaibara T, Saunders JK, Sutherland GR (2000) Advances in mobile intraoperative magnetic resonance imaging. Neurosurgery 47: 131–138
Keles GE, Lamborn KR, Berger MS (2001) Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. J Neurosurg 95: 735–745
Knauth M, Wirtz CR, Tronnier VM et al (1999) Intraoperative MR imaging increases the extent of tumor resection in patients with high-grade gliomas. AJNR Am J Neuroradiol 20: 1642–1646
Kober H, Nimsky C, Möller M et al (2001) Correlation of sensorimotor activation with functional magnetic resonance imaging and magnetoencephalography in presurgical functional imaging: a spatial analysis. Neuroimage 14: 1214–1228
Kowalczuk A, Macdonald RL, Amidei C et al (1997) Quantitative imaging study of extent of surgical resection and prognosis of malignant astrocytomas. Neurosurgery 41: 1028–1038
Lacroix M, Abi-Said D, Fourney DR et al (2001) A multivariate analysis of 416_patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95: 190–198
Laws E (2003) Surgical management of intracranial gliomas does radical resection improve outcome? Acta Neurochir [Suppl] 85: 47–53
Laws ER, Parney IF, Huang W et al (2003) Survival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the Glioma Outcomes Project. J Neurosurg 99: 467–473
Martin CH, Schwartz R, Jolesz F et al (1999) Transsphenoidal resection of pituitary adenomas in an intraoperative MRI unit. Pituitary 2: 155–162
Mitchell P, Ellison DW, Mendelow AD (2005) Surgery for malignant gliomas: mechanistic reasoning and slippery statistics. Lancet Neurol 4: 413–422
Nicolato A, Gerosa MA, Fina P et al (1995) Prognostic factors in low-grade supratentorial astrocytomas: a uni-multivariate statistical analysis in 76_surgically treated adult patients.Surg Neurol 44: 208–223
Nimsky C, Fujita A, Ganslandt O et al (2004) Volumetric assessment of glioma removal by intraoperative high-field magnetic resonance imaging. Neurosurgery 55: 358–371
Nimsky C, Ganslandt O, Buchfelder M et al (2003) Glioma surgery evaluated by intraoperative low-field magnetic resonance imaging. Acta Neurochir [Suppl] 85: 55–63
Nimsky C, Ganslandt O, Buchfelder M et al (2006) Intraoperative visualization for resection of gliomas: the role of functional neuronavigation and intraoperative 1.5_Tesla MRI.Neurol Res [in press]
Nimsky C, Ganslandt O, Fahlbusch R (2004) Functional neuronavigation and intraoperative MRI. Adv Tech Stand Neurosurg 29: 229–263
Nimsky C, Ganslandt O, Fahlbusch R (2005) 1.5_T: intraoperative imaging beyond standard anatomic imaging. Neurosurg Clin N Am 16: 185–200, vii
Nimsky C, Ganslandt O, Fahlbusch R (2005) Comparing 0.2 tesla with 1.5_tesla intraoperative magnetic resonance imaging analysis of setup, workflow, and efficiency. Acad Radiol 12: 1065–1079
Nimsky C, Ganslandt O, Hastreiter P et al (2005) Intraoperative diffusion-tensor MR imaging: shifting of white matter tracts during neurosurgical procedures-initial experience. Radiology 234: 218–225
Nimsky C, Ganslandt O, Hastreiter P et al (2005) Preoperative and intraoperative diffusion tensor imaging-based fiber tracking in glioma surgery. Neurosurgery 56: 130–138
Nimsky C, Ganslandt O, Keller v B et al (2003) Preliminary experience in glioma surgery with intraoperative high-field MRI. Acta Neurochir Suppl 88: 21–29
Nimsky C, Ganslandt O, Keller v B et al (2004) Intraoperative high-field-strengthMRimaging: implementation and experience in 200_patients. Radiology 233: 67–78
Nimsky C, Ganslandt O, Kober H et al (1999) Integration of functional magnetic resonance imaging supported by magnetoencephalography in functional neuronavigation. Neurosurgery 44: 1249–1256
Nimsky C, Ganslandt O, Merhof D et al (2006) Intraoperative visualization of the pyramidal tract by diffusion-tensor-imagingbased fiber tracking. Neuroimage [in press]
Nimsky C, Ganslandt O, Tomandl B et al (2002) Low-field magnetic resonance imaging for intraoperative use in neurosurgery: a 5_year experience. Eur Radiol 12: 2690–2703
Nimsky C, Grummich P, Sorensen AG et al (2005) Visualization of the pyramidal tract in glioma surgery by integrating diffusion tensor imaging in functional neuronavigation. Zentralbl Neurochir 66: 133–141
Oh DS, Black PM (2005) A low-field intraoperative MRI system for glioma surgery: is it worthwhile? Neurosurg Clin N Am 16: 135–141
Pergolizzi RS Jr, Nabavi A, Schwartz RB et al (2001) Intraoperative MR guidance during trans-sphenoidal pituitary resection: preliminary results. J Magn Reson Imaging 13: 136–141
Schneider JP, Trantakis C, Rubach M et al (2005) Intraoperative MRI to guide the resection of primary supratentorial glioblastoma multiforme-a quantitative radiological analysis. Neuroradiology 47: 489–500
Stadlbauer A, Moser E, Gruber S et al (2004) Improved delineation of brain tumors: an automated method for segmentation based on pathologic changes of 1H-MRSI metabolites in gliomas. Neuroimage 23: 454–461
Stadlbauer A, Moser E, Gruber S et al (2004) Integration of biochemical images of a tumor into frameless stereotaxy achieved using a magnetic resonance imaging/magnetic resonance spectroscopy hybrid data set. J Neurosurg 101: 287–294
Stark AM, Nabavi A, Mehdorn HM et al (2005) Glioblastoma multiforme-report of 267_cases treated at a single institution. Surg Neurol 63: 162–169
Ushio Y, Kochi M, Hamada J et al (2005) Effect of surgical removal on survival and quality of life in patients with supratentorial glioblastoma. Neurol Med Chir (Tokyo) 45: 454–460; discussion 460–451
Whittle IR (2002) Surgery for gliomas. Curr Opin Neurol 15: 663–669
Wirtz CR, Knauth M, Staubert A et al (2000) Clinical evaluation and follow-up results for intraoperative magnetic resonance imaging in neurosurgery. Neurosurgery 46: 1112–1122
Yeh SA, Ho JT, Lui CC et al (2005) Treatment outcomes and prognostic factors in patients with supratentorial low-grade gliomas. Br J Radiol 78: 230–235
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Springer-Verlag/Wien
About this chapter
Cite this chapter
Nimsky, C., Ganslandt, O., Keller, B.v., Fahlbusch, R. (2006). Intraoperative high-field MRI: anatomical and functional imaging. 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_12
Download citation
DOI: https://doi.org/10.1007/978-3-211-33303-7_12
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-33302-0
Online ISBN: 978-3-211-33303-7
eBook Packages: MedicineMedicine (R0)