Skip to main content

Low Field Intraoperative MRI in Glioma Surgery

  • Chapter
  • First Online:
Intraoperative Imaging

Part of the book series: Acta Neurochirurgica Supplementum ((NEUROCHIRURGICA,volume 109))

Abstract

The extent of resection marks one prognostic factor for patients with malignant gliomas. Among the methods used for the intraoperative control of the extent of resection, intraoperative magnetic resonance imaging (ioMRI) has become a very attractive method. It was introduced in the in the final decade of the last century. The first available system was a low magnetic field strength unit employing 0.5Tesla (T). While currently high-field systems (1.5T and above) are being developed, different low-field ioMRI systems (0.5T and below) have been used for brain tumor resection in far more centers than high-field ioMRI, corresponding to a greater number of publications. Undoubtedly, high-field ioMRI systems offer superior image quality and faster acquisition times. Yet, low-field ioMRI has influenced intraoperative decision-making and improved brain tumor resection. With this article, we review the use of low-field ioMRI in glioma surgery.

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 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
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

References

  1. Bennett AH, Godlee RJ (1974) A case of cerebral tumor – the surgical treatment. CA Cancer J Clin 24:171–181 (excerpt from Trans R Med Chir Soc Lond 168:243–275, 1885)

    Article  PubMed  CAS  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. McGirt MJ, Chaichana KL, Gathinji M, Attenello FJ, Than K, Olivi A, Weingart JD, Brem H, Quinones-Hinojosa A (2009) Independent association of extent of resection with survival in patients with malignant brain astrocytoma. J Neurosurg 110:156–162

    Google Scholar 

  4. Sanai N, Berger MS (2008) Glioma extent of resection and its impact on patient outcome. Neurosurgery 62:753–764, discussion 264–756

    Article  PubMed  Google Scholar 

  5. Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ (2006) Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 7:392–401

    Article  PubMed  CAS  Google Scholar 

  6. Stummer W, Reulen HJ, Meinel T, Pichlmeier U, Schumacher W, Tonn JC, Rohde V, Oppel F, Turowski B, Woiciechowsky C, Franz K, Pietsch T (2008) Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias. Neurosurgery 62:564–576, discussion 564–576

    Article  PubMed  Google Scholar 

  7. 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, discussion 60–61

    Article  PubMed  CAS  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. Hall WA, Liu H, Martin AJ, Truwit CL (2000) Intraoperative magnetic resonance imaging. Top Magn Reson Imaging 11: 203–212

    Article  PubMed  CAS  Google Scholar 

  10. Senft C, Seifert V, Hermann E, Gasser T (2009) Surgical treatment of cerebral abscess with the use of a mobile ultralow-field MRI. Neurosurg Rev 32:77–85

    Article  PubMed  Google Scholar 

  11. Black PM, Moriarty T, Alexander E 3rd, 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, discussion 842–845

    Article  PubMed  CAS  Google Scholar 

  12. Seifert V, Zimmermann M, Trantakis C, Vitzthum HE, Kuhnel K, Raabe A, Bootz F, Schneider JP, Schmidt F, Dietrich J (1999) Open MRI-guided neurosurgery. Acta Neurochir (Wien) 141:455–464

    Article  CAS  Google Scholar 

  13. 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, discussion 900–902

    Article  PubMed  CAS  Google Scholar 

  14. Wirtz CR, Bonsanto MM, Knauth M, Tronnier VM, Albert FK, Staubert A, Kunze S (1997) Intraoperative magnetic resonance imaging to update interactive navigation in neurosurgery: method and preliminary experience. Comput Aided Surg 2:172–179

    PubMed  CAS  Google Scholar 

  15. Bohinski RJ, Kokkino AK, Warnick RE, Gaskill-Shipley MF, Kormos DW, Lukin RR, Tew JM Jr (2001) Glioma resection in a shared-resource magnetic resonance operating room after optimal image-guided frameless stereotactic resection. Neurosurgery 48:731–742, discussion 742–744

    PubMed  CAS  Google Scholar 

  16. Muragaki Y, Iseki H, Maruyama T, Kawamata T, Yamane F, Nakamura R, Kubo O, Takakura K, Hori T (2006) Usefulness of intraoperative magnetic resonance imaging for glioma surgery. Acta Neurochir Suppl 98:67–75

    Article  PubMed  CAS  Google Scholar 

  17. 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, discussion 807–809

    PubMed  CAS  Google Scholar 

  18. Schulder M, Salas S, Brimacombe M, Fine P, Catrambone J, Maniker AH, Carmel PW (2006) Cranial surgery with an expanded compact intraoperative magnetic resonance imager. Technical note. J Neurosurg 104:611–617

    Article  PubMed  Google Scholar 

  19. Ntoukas V, Krishnan R, Seifert V (2008) The new generation polestar n20 for conventional neurosurgical operating rooms: a preliminary report. Neurosurgery 62:82–89, discussion 89–90

    Article  PubMed  Google Scholar 

  20. Schulder M, Carmel PW (2003) Intraoperative magnetic resonance imaging: impact on brain tumor surgery. Cancer Control 10: 115–124

    PubMed  Google Scholar 

  21. 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, discussion 431–433

    Article  PubMed  CAS  Google Scholar 

  22. Knauth M, Wirtz CR, Tronnier VM, Aras N, Kunze S, Sartor K (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 

  23. Metzger AK, Lewin JS (2001) Optimizing brain tumor resection. Low-field interventional MR imaging. Neuroimaging Clin N Am 11:651–657, ix

    PubMed  CAS  Google Scholar 

  24. Nimsky C, Ganslandt O, Tomandl B, Buchfelder M, Fahlbusch R (2002) Low-field magnetic resonance imaging for intraoperative use in neurosurgery: a 5-year experience. Eur Radiol 12: 2690–2703

    PubMed  Google Scholar 

  25. Ram Z, Hadani M (2003) Intraoperative imaging – MRI. Acta Neurochir Suppl 88:1–4

    PubMed  CAS  Google Scholar 

  26. Schulder M, Sernas TJ, Carmel PW (2003) Cranial surgery and navigation with a compact intraoperative MRI system. Acta Neurochir Suppl 85:79–86

    Article  PubMed  CAS  Google Scholar 

  27. Zimmermann M, Seifert V, Trantakis C, Kuhnel K, Raabe A, Schneider JP, Dietrich J, Schmidt F (2000) Open MRI-guided microsurgery of intracranial tumours. Preliminary experience using a vertical open MRI-scanner. Acta Neurochir (Wien) 142: 177–186

    Article  CAS  Google Scholar 

  28. Hinks RS, Bronskill MJ, Kucharczyk W, Bernstein M, Collick BD, Henkelman RM (1998) MR systems for image-guided therapy. J Magn Reson Imaging 8:19–25

    Article  PubMed  CAS  Google Scholar 

  29. Lewin JS (1999) Interventional MR imaging: concepts, systems, and applications in neuroradiology. AJNR Am J Neuroradiol 20:735–748

    PubMed  CAS  Google Scholar 

  30. Senft C, Seifert V, Hermann E, Franz K, Gasser T (2008) Usefulness of intraoperative ultralow-field magnetic resonance imaging in glioma surgery. Neurosurgery 63:257–266, discussion 266–267

    Article  PubMed  Google Scholar 

  31. Knauth M, Wirtz CR, Aras N, Sartor K (2001) Low-field interventional MRI in neurosurgery: finding the right dose of contrast medium. Neuroradiology 43:254–258

    Article  PubMed  CAS  Google Scholar 

  32. Nimsky C, Ganslandt O, Buchfelder M, Fahlbusch R (2003) Glioma surgery evaluated by intraoperative low-field magnetic resonance imaging. Acta Neurochir Suppl 85:55–63

    Article  PubMed  CAS  Google Scholar 

  33. Roberts DW, Hartov A, Kennedy FE, Miga MI, Paulsen KD (1998) Intraoperative brain shift and deformation: a quantitative analysis of cortical displacement in 28 cases. Neurosurgery 43:749–758, discussion 758–760

    Article  PubMed  CAS  Google Scholar 

  34. Bergsneider M, Sehati N, Villablanca P, McArthur DL, Becker DP, Liau LM (2005) Mahaley Clinical Research Award: extent of glioma resection using low-field (0.2T) versus high-field (1.5T) intraoperative MRI and image-guided frameless neuronavigation. Clin Neurosurg 52:389–399

    PubMed  Google Scholar 

  35. Erdogan N, Tucer B, Mavili E, Menku A, Kurtsoy A (2005) Ultrasound guidance in intracranial tumor resection: correlation with postoperative magnetic resonance findings. Acta Radiol 46:743–749

    Article  PubMed  CAS  Google Scholar 

  36. Rygh OM, Selbekk T, Torp SH, Lydersen S, Hernes TA, Unsgaard G (2008) Comparison of navigated 3D ultrasound findings with histopathology in subsequent phases of glioblastoma resection. Acta Neurochir (Wien) 150:1031–1044

    Article  Google Scholar 

  37. Tronnier VM, Bonsanto MM, Staubert A, Knauth M, Kunze S, Wirtz CR (2001) Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions. Neurosurg Focus 10:E3

    Article  PubMed  CAS  Google Scholar 

  38. Buchfelder M, Fahlbusch R, Ganslandt O, Stefan H, Nimsky C (2002) Use of intraoperative magnetic resonance imaging in tailored temporal lobe surgeries for epilepsy. Epilepsia 43:864–873

    Article  PubMed  Google Scholar 

  39. 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 

  40. Wirtz CR, Knauth M, Staubert A, Bonsanto MM, Sartor K, Kunze S, Tronnier VM (2000) Clinical evaluation and follow-up results for intraoperative magnetic resonance imaging in neurosurgery. Neurosurgery 46:1112–1120, discussion 1120–1122

    Article  PubMed  CAS  Google Scholar 

  41. 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

    Article  PubMed  CAS  Google Scholar 

  42. Schneider JP, Trantakis C, Rubach M, Schulz T, Dietrich J, Winkler D, Renner C, Schober R, Geiger K, Brosteanu O, Zimmer C, Kahn T (2005) Intraoperative MRI to guide the resection of primary supratentorial glioblastoma multiforme – a quantitative radiological analysis. Neuroradiology 47:489–500

    Article  PubMed  Google Scholar 

  43. 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 

  44. Bernstein M, Al-Anazi AR, Kucharczyk W, Manninen P, Bronskill M, Henkelman M (2000) Brain tumor surgery with the Toronto open magnetic resonance imaging system: preliminary results for 36 patients and analysis of advantages, disadvantages, and future prospects. Neurosurgery 46:900–907, discussion 907–909

    PubMed  CAS  Google Scholar 

  45. Zimmermann M, Seifert V, Trantakis C, Raabe A (2001) Open MRI-guided microsurgery of intracranial tumours in or near eloquent brain areas. Acta Neurochir (Wien) 143:327–337

    Article  CAS  Google Scholar 

  46. Szelenyi A, Gasser T, Seifert V (2008) Intraoperative neurophysiological monitoring in an open low-field magnetic resonance imaging system: clinical experience and technical considerations. Neurosurgery 63:268–275, discussion 275–276

    Article  PubMed  Google Scholar 

  47. Trantakis C, Winkler D, Lindner D, Strauss G, Nagel C, Schneider JP, Meixensberger J (2003) Clinical results in MR-guided therapy for malignant gliomas. Acta Neurochir Suppl 85:65–71

    Article  PubMed  CAS  Google Scholar 

  48. Nimsky C, Ganslandt O, Hastreiter P, Wang R, Benner T, Sorensen AG, Fahlbusch R (2007) Preoperative and intraoperative diffusion tensor imaging-based fiber tracking in glioma surgery. Neurosurgery 61:178–185, discussion 186

    PubMed  Google Scholar 

  49. Ozawa N, Muragaki Y, Nakamura R, Lseki H (2008) Intraoperative diffusion-weighted imaging for visualization of the pyramidal tracts. Part II: clinical study of usefulness and efficacy. Minim Invasive Neurosurg 51:67–71

    Article  PubMed  CAS  Google Scholar 

  50. Schulder M, Azmi H, Biswal B (2003) Functional magnetic resonance imaging in a low-field intraoperative scanner. Stereotact Funct Neurosurg 80:125–131

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Volker Seifert .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag/Wien

About this chapter

Cite this chapter

Seifert, V., Gasser, T., Senft, C. (2011). Low Field Intraoperative MRI in Glioma Surgery. In: Pamir, M., Seifert, V., Kiris, T. (eds) Intraoperative Imaging. Acta Neurochirurgica Supplementum, vol 109. Springer, Vienna. https://doi.org/10.1007/978-3-211-99651-5_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-99651-5_6

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-99650-8

  • Online ISBN: 978-3-211-99651-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics