Skip to main content

Intraoperative high-field MRI: anatomical and functional imaging

  • Chapter
Book cover Medical Technologies in Neurosurgery

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

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Albayrak B, Samdani AF, Black PM (2004) Intra-operative magnetic resonance imaging in neurosurgery. Acta Neurochir (Wien) 146: 543–557

    Article  CAS  Google Scholar 

  2. 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

    Article  PubMed  CAS  Google Scholar 

  3. 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

    Article  PubMed  CAS  Google Scholar 

  4. 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

    Article  PubMed  CAS  Google Scholar 

  5. 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

    Article  PubMed  CAS  Google Scholar 

  6. 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

    PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Article  PubMed  CAS  Google Scholar 

  12. Fahlbusch R, Ganslandt O, Buchfelder M et al (2001) Intraoperative magnetic resonance imaging during transsphenoidal surgery. J Neurosurg 95: 381–390

    PubMed  CAS  Google Scholar 

  13. 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

    Article  PubMed  CAS  Google Scholar 

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. Gasser T, Ganslandt O, Sandalcioglu E et al (2005) Intraoperative functional MRI: implementation and preliminary experience.Neuroimage 26: 685–693

    Article  PubMed  Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. Henson JW, Gaviani P, Gonzalez RG (2005) MRI in treatment of adult gliomas. Lancet Oncol 6: 167–175

    Article  PubMed  Google Scholar 

  20. Hentschel SJ, Sawaya R (2003) Optimizing outcomes with maximal surgical resection of malignant gliomas. Cancer Control 10: 109–114

    PubMed  Google Scholar 

  21. 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

    Article  PubMed  CAS  Google Scholar 

  22. Kaibara T, Saunders JK, Sutherland GR (2000) Advances in mobile intraoperative magnetic resonance imaging. Neurosurgery 47: 131–138

    Article  PubMed  CAS  Google Scholar 

  23. 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

    PubMed  CAS  Google Scholar 

  24. 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

    PubMed  CAS  Google Scholar 

  25. 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

    Article  PubMed  CAS  Google Scholar 

  26. 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

    Article  PubMed  CAS  Google Scholar 

  27. 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

    PubMed  CAS  Google Scholar 

  28. Laws E (2003) Surgical management of intracranial gliomas does radical resection improve outcome? Acta Neurochir [Suppl] 85: 47–53

    CAS  Google Scholar 

  29. 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

    PubMed  Google Scholar 

  30. Martin CH, Schwartz R, Jolesz F et al (1999) Transsphenoidal resection of pituitary adenomas in an intraoperative MRI unit. Pituitary 2: 155–162

    Article  PubMed  CAS  Google Scholar 

  31. Mitchell P, Ellison DW, Mendelow AD (2005) Surgery for malignant gliomas: mechanistic reasoning and slippery statistics. Lancet Neurol 4: 413–422

    Article  PubMed  Google Scholar 

  32. 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

    Article  PubMed  CAS  Google Scholar 

  33. 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

    Article  PubMed  Google Scholar 

  34. 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

    CAS  Google Scholar 

  35. 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]

    Google Scholar 

  36. Nimsky C, Ganslandt O, Fahlbusch R (2004) Functional neuronavigation and intraoperative MRI. Adv Tech Stand Neurosurg 29: 229–263

    PubMed  CAS  Google Scholar 

  37. Nimsky C, Ganslandt O, Fahlbusch R (2005) 1.5_T: intraoperative imaging beyond standard anatomic imaging. Neurosurg Clin N Am 16: 185–200, vii

    Article  PubMed  Google Scholar 

  38. 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

    Article  PubMed  Google Scholar 

  39. 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

    Article  PubMed  Google Scholar 

  40. 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

    PubMed  Google Scholar 

  41. 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

    PubMed  CAS  Google Scholar 

  42. Nimsky C, Ganslandt O, Keller v B et al (2004) Intraoperative high-field-strengthMRimaging: implementation and experience in 200_patients. Radiology 233: 67–78

    Article  PubMed  Google Scholar 

  43. 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

    Article  PubMed  Google Scholar 

  44. Nimsky C, Ganslandt O, Merhof D et al (2006) Intraoperative visualization of the pyramidal tract by diffusion-tensor-imagingbased fiber tracking. Neuroimage [in press]

    Google Scholar 

  45. 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

    PubMed  Google Scholar 

  46. 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

    Article  PubMed  CAS  Google Scholar 

  47. Oh DS, Black PM (2005) A low-field intraoperative MRI system for glioma surgery: is it worthwhile? Neurosurg Clin N Am 16: 135–141

    Article  PubMed  Google Scholar 

  48. 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

    Article  PubMed  Google Scholar 

  49. 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

    Article  PubMed  Google Scholar 

  50. 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

    Article  PubMed  Google Scholar 

  51. 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

    PubMed  Google Scholar 

  52. 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

    Article  PubMed  Google Scholar 

  53. 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

    Article  Google Scholar 

  54. Whittle IR (2002) Surgery for gliomas. Curr Opin Neurol 15: 663–669

    Article  PubMed  Google Scholar 

  55. 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

    Article  PubMed  CAS  Google Scholar 

  56. 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

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints 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)

Publish with us

Policies and ethics