3-T intraoperative MRI (iMRI) for pediatric epilepsy surgery

Warsi, Nebras M.; Lasry, Oliver; Adel, Farah; Saint‐Martin, Christine; Montes, José L.; Atkinson, Jeffrey; Farmer, Jean‐Pierre; Dudley, Roy

doi:10.1007/s00381-016-3263-3

Cited by 11 publications

(27 citation statements)

References 26 publications

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“…For instance, use of iMRI in tumor surgery, epilepsy surgery, and ventricular catheter placement has been reported. [18][19][20] Although there is a lack of useful fluorescent dyes in pediatric neurosurgery and iMRI is an established tool in adult high-grade glioma surgery, [6][7][8] data rated as level I evidence to promote the use of iMRI in pediatric neurosurgery are lacking. Thus, we did a meta-analysis to evaluate histopathologic entities that were operated on, the number of iMRI scans and additional resections secondary to iMRI, the improvement of the rate of complete resections in gliomas, and the rate of surgical site infections (SSIs) after brain tumor surgery with iMRI guidance in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative MRI-guided Resection in Pediatric Brain Tumor Surgery: A Meta-analysis of Extent of Resection and Safety Outcomes

Wach

Banat

Borger

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background The objective of this meta-analysis was to analyze the impact of intraoperative magnetic resonance imaging (iMRI) on pediatric brain tumor surgery with regard to the frequency of histopathologic entities, additional resections secondary to iMRI, rate of gross total resections (GTR) in glioma surgery, extent of resection (EoR) in supra- and infratentorial compartment, surgical site infections (SSIs), and neurologic outcome after surgery. Methods MEDLINE/PubMed Service was searched for the terms “intraoperative MRI,” “pediatric,” “brain,” “tumor,” “glioma,” and “surgery.” The review produced 126 potential publications; 11 fulfilled the inclusion criteria, including 584 patients treated with iMRI-guided resections. Studies reporting about patients <18 years, setup of iMRI, surgical workflow, and extent of resection of iMRI-guided glioma resections were included. Results IMRI-guided surgery is mainly used for pediatric low-grade gliomas. The mean rate of GTR in low- and high-grade gliomas was 78.5% (207/254; 95% confidence interval [CI]: 64.6–89.7, p < 0.001). The mean rate of GTR in iMRI-assisted low-grade glioma surgery was 74.3% (35/47; 95% CI: 61.1–85.5, p = 0.759). The rate of SSI in surgery assisted by iMRI was 1.6% (6/482; 95% CI: 0.7–2.9). New onset of transient postoperative neurologic deficits were observed in 37 (33.0%) of 112 patients. Conclusion IMRI-guided surgery seems to improve the EoR in pediatric glioma surgery. The rate of SSI and the frequency of new neurologic deficits after IMRI-guided surgery are within the normal range of pediatric neuro-oncologic surgery.

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Section: Introductionmentioning

confidence: 99%

Intraoperative MRI-guided Resection in Pediatric Brain Tumor Surgery: A Meta-analysis of Extent of Resection and Safety Outcomes

Wach

Banat

Borger

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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“…also included paediatric patients with other neurological lesions, including malformations of cortical development and mesial temporal sclerosis. These studies did not distinguish between seizure outcomes based on pathology type 39,40 . This may limit the finding's generalisability to populations comprised mainly of paediatric epilepsy patients with brain tumours.…”

Section: Discussionmentioning

confidence: 95%

“…listed the specific pathologies, their findings did not distinguish between brain tumours and other lesions. In contrast, Warsi et al 40 . broadly classified their pathologies on whether they were well‐defined, poorly defined or diffuse hemispheric cases.…”

Section: Resultsmentioning

confidence: 99%

“…Of the identified studies, three investigated the use of iMRI during epilepsy surgery and its effect on seizure outcomes 39–41 . Warsi et al 40 .…”

Section: Discussionmentioning

confidence: 99%

“…It is important to note, however, that the studies by Eid et al 39 . and Warsi et al 40 . also included paediatric patients with other neurological lesions, including malformations of cortical development and mesial temporal sclerosis.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating the use of intraoperative magnetic resonance imaging in paediatric brain tumour resection surgeries: a literature review

Wu,

Clift,

Hilliard

et al. 2023

J of Medical Radiation Sci

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Brain tumours are the most common solid neoplasm in children, posing a significant challenge in oncology due to the limited range of treatment. Intraoperative magnetic resonance imaging (iMRI) has recently emerged to aid surgical intervention in neurosurgery resection with the potential to delineate tumour boundaries. This narrative literature review aimed to provide an updated evaluation of the clinical implementation of iMRI in paediatric neurosurgical resection, with an emphasis on the extent of brain tumour resection, patient outcomes and its drawbacks. Databases including MEDLINE, PubMed, Scopus and Web of Science were used to investigate this topic with key terms: paediatric, brain tumour, and iMRI. Exclusion criteria included literature comprised of adult populations and the use of iMRI in neurosurgery in the absence of brain tumours. The limited body of research evaluating the clinical implementation of iMRI in paediatric cohorts has been predominantly positive. Current evidence demonstrates the potential for iMRI use to increase rates of gross total resection (GTR), assess the extent of resection, and improve patient outcomes, such as progression‐free survival. Limitations regarding the use of iMRI include prolonged operation times and complications associated with head immobilisation devices. iMRI has the potential to aid in the achievement of maximal brain tumour resection in paediatric patients. Future prospective randomised controlled trials are necessary to determine the clinical significance and benefits of using iMRI during neurosurgical resection for clinical management of brain neoplasms in children.

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The impact of intraoperative magnetic resonance in routine pediatric neurosurgical practice—a 6-year appraisal

et al. 2018

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3-T intraoperative MRI (iMRI) for pediatric epilepsy surgery

Cited by 11 publications

References 26 publications

Intraoperative MRI-guided Resection in Pediatric Brain Tumor Surgery: A Meta-analysis of Extent of Resection and Safety Outcomes

Intraoperative MRI-guided Resection in Pediatric Brain Tumor Surgery: A Meta-analysis of Extent of Resection and Safety Outcomes

Evaluating the use of intraoperative magnetic resonance imaging in paediatric brain tumour resection surgeries: a literature review

The impact of intraoperative magnetic resonance in routine pediatric neurosurgical practice—a 6-year appraisal

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