Comparison of intraoperative and post-operative 3-T MRI performed at 24–72 h following brain tumour resection in children

Avula, Shivaram; Jaspan, Tim; Pizer, Barry; Pettorini, Benedetta; Garlick, Deborah; Hennigan, Dawn; Mallucci, Conor

doi:10.1007/s00234-021-02671-5

Cited by 11 publications

(23 citation statements)

References 19 publications

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“…With increasing use of intraoperative MRI, the validity of the final intraoperative scan as the baseline scan has been debated. Based on a single centre study and consensus among the SIOPE brain imaging group, it has been agreed that the final intraoperative MRI scan is now acceptable as the baseline, provided it is from a 3-T scanner (as it has been only validated on 3 T); this SIOPE brain tumour protocol is followed, is supervised by a radiologist experienced in children's brain tumours and is reported in consensus with the operating neurosurgeon [37]. The preoperative and final intraoperative sequences must be comparable.…”

Section: Early Postoperative Imagingmentioning

confidence: 99%

European Society for Paediatric Oncology (SIOPE) MRI guidelines for imaging patients with central nervous system tumours

et al. 2021

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Introduction Standardisation of imaging acquisition is essential in facilitating multicentre studies related to childhood CNS tumours. It is important to ensure that the imaging protocol can be adopted by centres with varying imaging capabilities without compromising image quality. Materials and method An imaging protocol has been developed by the Brain Tumour Imaging Working Group of the European Society for Paediatric Oncology (SIOPE) based on consensus among its members, which consists of neuroradiologists, imaging scientists and paediatric neuro-oncologists. This protocol has been developed to facilitate SIOPE led studies and regularly reviewed by the imaging working group. Results The protocol consists of essential MRI sequences with imaging parameters for 1.5 and 3 Tesla MRI scanners and a set of optional sequences that can be used in appropriate clinical settings. The protocol also provides guidelines for early post-operative imaging and surveillance imaging. The complementary use of multimodal advanced MRI including diffusion tensor imaging (DTI), MR spectroscopy and perfusion imaging is encouraged, and optional guidance is provided in this publication. Conclusion The SIOPE brain tumour imaging protocol will enable consistent imaging across multiple centres involved in paediatric CNS tumour studies.

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Section: Early Postoperative Imagingmentioning

confidence: 99%

European Society for Paediatric Oncology (SIOPE) MRI guidelines for imaging patients with central nervous system tumours

et al. 2021

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“…The literature search on PubMed yielded 128 articles, of which ten met our inclusion criteria ( Figure 1 ; Table 1 ) ( Abernethy et al, 2012 ; Yousaf et al, 2012 ; Avula et al, 2013 ; Ren et al, 2013 ; Giordano et al, 2017 ; Tejada et al, 2018 ; Saint-Martin et al, 2019 ; Low et al, 2020 ; Avula et al, 2021 ; Sunderland et al, 2021 ). Most of these studies were cohort studies, two were case series ( Abernethy et al, 2012 ; Ren et al, 2013 ), one included a review of experience ( Abernethy et al, 2012 ), and one included a comparison of their results to existing literature ( Low et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…All studies that resulted from our PubMed search were performed on either a 1.5 or 3 Tesla MRI scanner. These studies aimed to report the initial ioMRI experience, to evaluate early repeat resection ( Avula et al, 2013 ), to detect ischemic infarcts on diffusion ioMRI ( Saint-Martin et al, 2019 ), or to evaluate ioMRI scans as post-operative scans ( Avula et al, 2021 ). The included studies described a heterogeneous group of histopathological brain tumors with advanced MRI ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Advanced intraoperative MRI in pediatric brain tumor surgery

et al. 2023

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Introduction: In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides “real-time” imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging.Methods: Our systematic literature search identified relevant articles on PubMed using keywords associated with pediatrics, ioMRI, and brain tumors. The literature search was extended using the snowball technique to gather more information on advanced MRI techniques, their technical background, their use in adult ioMRI, and their use in routine pediatric brain tumor care.Results: The available literature was sparse and demonstrated that advanced sequences were used to reconstruct fibers to prevent damage to important structures, provide information on relative cerebral blood flow or abnormal metabolites, or to indicate the onset of hemorrhage or ischemic infarcts. The explorative literature search revealed developments within each advanced MRI field, such as multi-shell diffusion MRI, arterial spin labeling, and amide-proton transfer-weighted imaging, that have been studied in adult ioMRI but have not yet been applied in pediatrics. These techniques could have the potential to provide more accurate fiber tractography, information on intraoperative cerebral perfusion, and to match gadolinium-based T1w images without using a contrast agent.Conclusion: The potential added value of advanced MRI in the intraoperative setting for pediatric brain tumors is to prevent damage to important structures, to provide additional physiological or metabolic information, or to indicate the onset of postoperative changes. Current developments within various advanced ioMRI sequences are promising with regard to providing in-depth tissue information.

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“…In current guidelines, it is only accepted if it has been done on a 3-T scanner, but in our experience, our image quality is good enough to use the final ioMRI at 1.5 T as a baseline examination for future follow-up, although more studies are needed in this area ( 17 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

The impact of 1.5-T intraoperative magnetic resonance imaging in pediatric tumor surgery: Safety, utility, and challenges

et al. 2023

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ObjectiveIn this study, we present our experience with 1.5-T high-field intraoperative magnetic resonance imaging (ioMRI) for different neuro-oncological procedures in a pediatric population, and we discuss the safety, utility, and challenges of this intraoperative imaging technology.MethodsA pediatric consecutive-case series of neuro-oncological surgeries performed between February 2020 and May 2022 was analyzed from a prospective ioMRI registry. Patients were divided into four groups according to the surgical procedure: intracranial tumors (group 1), intraspinal tumors (group 2), stereotactic biopsy for unresectable tumors (group 3), and catheter placement for cystic tumors (group 4). The goal of surgery, the volume of residual tumor, preoperative and discharge neurological status, and postoperative complications related to ioMRI were evaluated.ResultsA total of 146 procedures with ioMRI were performed during this period. Of these, 62 were oncology surgeries: 45 in group 1, two in group 2, 10 in group 3, and five in group 4. The mean age of our patients was 8.91 years, with the youngest being 12 months. ioMRI identified residual tumors and prompted further resection in 14% of the cases. The mean time for intraoperative image processing was 54 ± 6 min. There were no intra- or postoperative security incidents related to the use of ioMRI. The reoperation rate in the early postoperative period was 0%.ConclusionioMRI in pediatric neuro-oncology surgery is a safe and reliable tool. Its routine use maximized the extent of tumor resection and did not result in increased neurological deficits or complications in our series. The main limitations included the need for strict safety protocols in a highly complex surgical environment as well as the inherent limitations on certain patient positions with available MR-compatible headrests.

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Comparison of intraoperative and post-operative 3-T MRI performed at 24–72 h following brain tumour resection in children

Cited by 11 publications

References 19 publications

European Society for Paediatric Oncology (SIOPE) MRI guidelines for imaging patients with central nervous system tumours

European Society for Paediatric Oncology (SIOPE) MRI guidelines for imaging patients with central nervous system tumours

Advanced intraoperative MRI in pediatric brain tumor surgery

The impact of 1.5-T intraoperative magnetic resonance imaging in pediatric tumor surgery: Safety, utility, and challenges

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