Summary
The resection of brain tumors is limited by the surgeon’ s ability to precisely define margins. To overcome this problem, various neuronavigational tools have been used. The development of imageguided navigation systems represents a substantial improvement in the microsurgical treatment of various intracranial lesions. However, a major drawback of this technology is that they use images acquired preoperatively, on which the surgical planning and intraoperative performance is based. As the intracranial anatomy dynamically changes during a neurosurgical procedure, only intraoperatively acquired images can provide the neurosurgeon with the information needed to perform real-time, image-guided surgery. Because magnetic resonance imaging best delineates the soft-tissue extent of most tumors, it currently remains the superior method for intraoperative image guidance. In this review, we outline the development as well as current and possible future applications of the intraoperative MRI (iMRI) unit at the Brigham and Women’s Hospital, Boston, MA.
This is a preview of subscription content, log in via an institution to check access.
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: 543–556
Albert FK, Forsting M, Sartor K, Adams HP, Kunze S (1994) Early post-operative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis. Neurosurgery 34: 45–61
Apuzzo ML, Sabshin JK (1983) Comuputed tomographic guidance stereotaxis in the management of intracranial mass lesions. Neurosurgery 12: 277–285
Barnett GH (1999) The role of image-guided technology in the surgical planning and resection of gliomas. J Neurooncol 42: 247–258
Bernays RL, Kollias SS, Khan N, Brandner S, Meier S, Yonekawa Y (2002) Histological yield, complications, and technological considerations in 114_consecutive frameless stereotactic biopsy procedures aided by open intraoperative magnetic resonance imaging. J Neurosurg 97: 354–362
Black PM, Alexander E 3rd, Martin C, Moriarty T, Nabavi A, Wong TZ, Schwartz RB, Jolesz F (1999) Craniotomy for tumor treatment in an intraoperative magnetic resonance imaging unit. Neurosurgery 45: 423–431
Bohinski RJ, Warnick RE, Gaskill-Shipley MF, Zuccarello M, van Loveren HR, Kormos DW, Tew JM Jr (2001) Intraoperative magnetic resonance imaging to determine the extent of resection of pituitary macroadenomas during transsphenoidal microsurgery. Neurosurgery 49: 1133–1143
Claus EB, Horlacher A, Hsu L, Schwartz RB, Dello-Iacono D, Talos F, Jolesz FA, Black PM (2005) Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance. Cancer 103: 1227–1233
Hall WA, Truwit CL (2005) Intraoperative MR imaging.Magn Reson Imaging Clin N Am 13: 533–543
Hartkens T, Hill DL, Castellano-Smith AD, Hawkes DJ, Maurer CR Jr, Martin AJ, Hall WA, Liu H, Truwit CL (2003) Measurement and analysis of brain deformation during neurosurgery. IEEE Trans Med Imaging 22: 82–92
Hein PA, Eskey CJ, Dunn JF, Hug EB (2004) diffusionweighted imaging in the follow-up of treated high-grade gliomas: tumor recurrence versus radiation injury. Am J Neuroradiol 25: 201–209
Hirschberg H, Samset E, Hol PK, Tillung T, Lote K (2005) Impact of intraoperative MRI on the surgical results for high-grade gliomas. Minim Invasive Neurosurg 48: 77–84
Jolesz FA, Morrison PR, Koran SJ, Kelley RJ, Hushek SG, Newman RW, Fried MP, Melzer A, Seibel RM, Jalahej H (1998) Compatible instrumentation for intraoperative MRI: expanding resources. J Magn Reson Imaging 8: 8–11
Jolesz FA, Shtern F (1992) The operating room of the future. Report of the national cancer institute workshop, imagingguided stereotactic tumor diagnosis and treatment. Invest Radio 27: 326–328
Kanal E, Shellock FG (1992) Patient monitoring during clinical MR imaging. Radiology 185: 623–629
Karlik SJ, Heatherley T, Pavan F, Stein J, Lebron F, Rutt B, Carey L, Wexler R, Gelb A (1988) Patient anesthesia and monitoring at a 1.5-T MRI installation. Magn Reson Med 7: 210–221
Keeler EK, Casey FX, Engels H, Lauder E, Pirto CA, Reisker T, Rogers J, Schaefer DJ, Tynes T (1998) Accessory equipment considerations with respect to MRI compatibility. J Magn Reson Imaging 8: 12–18
Kelly PJ (1990) Image-directed tumor resection. Neurosurg Clin N Am 1: 81–95
Nabavi A, Gering DT, Kacher DF, Talos IF, Wells WM, Kikinis R, Black PM, Jolesz FA (2003) Surgical navigation in the open MRI. Acta Neurochir [Suppl] 85: 121–125
Nimsky C, Fujita A, Ganslandt O, Von Keller B, Fahlbusch R (2004) Volumetric assessment of glioma removal by intraoperative high-field magnetic resonance imaging. Neurosurgery 55: 358–370
Schenck JF, Jolesz FA, Roemer PB, Cline HE, Lorensen WE, Kikinis R, Silverman SG, Hardy CJ, Barber WD, Laskaris ET, et al (1995) Superconducting open-configuration MR imaging system for image-guided therapy. Radiology 195: 805–814
Schwartz RB, Carvalho PA, Alexander E 3rd, Loeffler JS, Folkerth R, Holman BL (1991) Radiation necrosis vs high-grade recurrent glioma: differentiation by using dual-isotope SPECT with 201Tl and 99mTc-HMPAO. Am J Neuroradiol 12: 1187–1192
Schwartz RB, Hsu L, Black PM, Alexander E 3rd, Wong TZ, Klufas RA, Moriarty T, Martin C, Isbister HG, Cahill CD, Spaulding SA, Kanan AR, Jolesz FA (1998) Evaluation of intracranial cysts by intraoperative MR. J Magn Reson Imaging 8:807–813
Schwartz RB, Hsu L, Wong TZ, Kacher DF, Zamani AA, Black PM, Alexander E 3rd, Stieg PE, Moriarty TM, Martin CA, Kikinis R, Jolesz FA (1999) Intraoperative MR imaging guidance for intracranial neurosurgery: experience with the first 200_cases. Radiology 211: 477–488
Shellock FG, Kanal E (1996) Burns associated with the use of monitoring equipment during MR procedures. J Magn Reson Imaging 6: 271–272
Shellock FG, Kanal E (1994) Guidelines and recommendations for MR imaging safety and patient management. III. Questionnaire for screening patients before MR procedures. The SMRI Safety Committee. J Magn Reson Imaging 4: 749–751
Silverman SG, Collick BD, Figueira MR, Khorasani R, Adams DF, Newman RW, Topulos GP, Jolesz FA (1995) Interactive MR-guided biopsy in an open-configuration MR imaging system. Radiology 197: 175–181
Spivak CJ, Pirouzmand F (2005) Comparison of the reliability of brain lesion localization when using traditional and stereotactic image-guided techniques: a prospective study. J Neurosurg 103: 424–427
Wendt RE 3rd, Rokey R, Vick GW 3rd, Johnston DL (1988) Electrocardiographic gating and monitoring in NMR imaging. Magn Reson Imaging 6: 89–95
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
Mittal, S., Black, P.M. (2006). Intraoperative magnetic resonance imaging in neurosurgery: the Brigham concept. 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_11
Download citation
DOI: https://doi.org/10.1007/978-3-211-33303-7_11
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-33302-0
Online ISBN: 978-3-211-33303-7
eBook Packages: MedicineMedicine (R0)