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Intraoperative 3-Tesla MRI in the management of paediatric cranial tumours—initial experience

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Abstract

Background

Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children.

Objectives

To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours.

Materials and methods

Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed.

Results

In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI.

Conclusion

In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation.

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Authors and Affiliations

  1. Department of Radiology, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK

    Shivaram Avula, Deborah Garlick & Laurence J. Abernethy

  2. Department of Neurosurgery, Alder Hey Children’s Hospital, Liverpool, UK

    Connor L. Mallucci

  3. Department of Oncology, Alder Hey Children’s Hospital, Liverpool, UK

    Barry Pizer

  4. Department of Pathology, Walton Centre for Neurology and Neurosurgery, Liverpool, UK

    Daniel Crooks

Authors
  1. Shivaram Avula
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  2. Connor L. Mallucci
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  3. Barry Pizer
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  4. Deborah Garlick
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  5. Daniel Crooks
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  6. Laurence J. Abernethy
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Corresponding author

Correspondence to Shivaram Avula.

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Avula, S., Mallucci, C.L., Pizer, B. et al. Intraoperative 3-Tesla MRI in the management of paediatric cranial tumours—initial experience. Pediatr Radiol 42, 158–167 (2012). https://doi.org/10.1007/s00247-011-2261-6

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  • DOI: https://doi.org/10.1007/s00247-011-2261-6

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