Abstract
Purpose
Intraoperative MRI (ioMRI) is a valuable tool aiding paediatric brain tumour resection. There is no published evidence comparing the effectiveness of the final intraoperative MRI and early post-operative (24–72 h) MRI as baseline scans following brain tumour resection. We aimed to evaluate whether the final ioMRI scan could serve as the post-operative baseline scan after paediatric brain tumour resections.
Methods
This prospective study compared the final ioMRI scan with the immediate post-operative MRI scan performed 24–72 h post-surgery. We included 20 patients aged 6.6–21 years undergoing brain tumour resection using ioMRI and were suitable for MRI scan without general anaesthesia. The scans were independently evaluated by experienced local and external paediatric neuroradiologists. Identical sequences in the final ioMRI and the 24–72-h MRI were compared to assess the extent of resection, imaging characteristics of residual tumour, the surgical field, extent of surgically induced contrast enhancement, and diffusion abnormalities.
Results
In 20 patients undergoing intraoperative and early post-operative MRI, there was no difference between ioMRI and 24–72-h post-op scans in identifying residual tumour. Surgically induced contrast enhancement was similar in both groups. There were more abnormalities on diffusion imaging and a greater degree of oedema around the surgical cavity on the 24–72-h scan.
Conclusion
The final 3-T ioMRI scan may be used as a baseline post-operative scan provided standard imaging guidelines are followed and is evaluated jointly by the operating neurosurgeon and neuroradiologist. Advantages of final ioMRI as a baseline scan are identified.
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Shivaram Avula: Conceptualization, methodology, implementation, analysis, and writing—original draft
Tim Jaspan: Methodology, implementation, analysis, and writing—review and editing
Barry Pizer: Methodology, implementation, and writing—review and editing
Benedetta Pettorini: Methodology, implementation, and writing—review and editing
Deborah Garlick: Implementation and writing—review and editing
Dawn Hennigan: Implementation and writing—review and editing
Conor Mallucci: Methodology, implementation, and writing—review and editing
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As the study involved comparison with standard clinical methodology and patients did not require additional general anaesthesia, it did not require consideration by the regional ethics committee and was registered as an institutional service evaluation study.
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Patients/carers had consented for the anonymised scans to be used for the purpose of research and audit.
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Avula, S., Jaspan, T., Pizer, B. et al. Comparison of intraoperative and post-operative 3-T MRI performed at 24–72 h following brain tumour resection in children. Neuroradiology 63, 1367–1376 (2021). https://doi.org/10.1007/s00234-021-02671-5
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DOI: https://doi.org/10.1007/s00234-021-02671-5