Intraoperative MRI with a Rotating, Tiltable Surgical Table: A Time–Use Study and Clinical Results in 122 Patients

Lewin, Jonathan S.; Nour, Sherif G.; Meyers, Mariana L.; Metzger, Andrew; Maciunas, Robert J.; Duerk, Jeffrey L.; Oppelt, A; Selman, Warren R.

doi:10.2214/ajr.06.1247

Cited by 28 publications

(13 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The literature has addressed different issues, such as the feasibility and general outcome of iMRI-guided transsphenoidal surgery, 2,3,5,10,14,25,27,28,31,34,40,45,46,[49][50][51]54,[57][58][59]65,66,71,77 and special issues such as its impact on endocrinological 9 and ophthalmological 10 outcomes or its use for acromega-ly. 29 Nevertheless, the benefit of iMRI for the growing number of patients in need of repeat surgery remains unclear.…”

mentioning

confidence: 99%

Intraoperative high-field MRI for transsphenoidal reoperations of nonfunctioning pituitary adenoma

Berkmann

Schlaffer

Nimsky

et al. 2014

JNS

View full text Add to dashboard Cite

Object. The loss of anatomical landmarks, frequently invasive tumor growth, and tissue changes make transsphenoidal reoperation of nonfunctioning pituitary adenomas (NFAs) challenging. The use of intraoperative MRI (iMRI) may lead to improved results. The goal of this retrospective study was to evaluate the impact of iMRI on transsphenoidal reoperations for NFA.Methods. Between September 2002 and July 2012, 109 patients underwent reoperations in which 111 transsphenoidal procedures were performed and are represented in this study. A 1.5-T Magnetom Sonata Maestro Class scanner (Siemens) was used for iMRI. Follow-up iMRI scans were acquired if gross-total resection (GTR) was suspected or if no further removal seemed possible.Results. Surgery was performed for tumor persistence and regrowth in 26 (23%) and 85 (77%) patients, respectively. On the initial iMRI scans, GTR was confirmed in 19 (17%) patients. Remnants were located as follows: 65 in the cavernous sinus (71%), 35 in the suprasellar space (38%), 9 in the retrosellar space (10%). Additional resection was possible in 62 (67%) patients, resulting in a significant volume reduction and increased GTR rate (49%). The GTR rates of invasive tumors on initial iMRI and postoperative MRI (poMRI) were 7% and 25%, respectively. Additional remnant resection was possible in 64% of the patients. Noninvasive tumors were shown to be totally resected on the initial iMRI in 31% of cases. After additional resection for 69% of the procedures, the GTR rate on poMRI was 75%. Transcranial surgery to resect tumor remnants was indicated in 5 (5%), and radiotherapy was performed in 29 (27%) patients. After GTR, no recurrence was detected during a mean follow-up of 2.2 ± 2.1 years.Conclusions. The use of iMRI in transsphenoidal reoperations for NFA leads to significantly higher GTR rates. It thus prevents additional operations and reduces the number of tumor remnants. The complication rates do not exceed the incidences reported in the literature for primary transsphenoidal surgery. If complete tumor resection is not possible, iMRI guidance can facilitate tumor volume reduction. (http://thejns.org/doi/abs/10.3171/2014.6.JNS131994) key WorDS • pituitary adenoma • intraoperative MRI • reoperation • tumor recurrence • transsphenoidal surgery • pituitary surgeryAbbreviations used in this paper: DI = diabetes insipidus; FSH = follicle-stimulating hormone; GKS = Gamma Knife surgery; GTR = gross-total resection; iMRI = intraoperative MRI; LH = luteinizing hormone; NFA = nonfunctioning pituitary adenoma; poMRI = postoperative MRI; VA = visual acuity; VF = visual field. J Neurosurg / Volume 121 / November 2014Intraoperative MRI for transsphenoidal reoperations 1167 ly.29 Nevertheless, the benefit of iMRI for the growing number of patients in need of repeat surgery remains unclear. The aim of this retrospective study was to evaluate the impact of iMRI on the extent of transsphenoidal reoperations in patients presenting with recurrent or persisting NFA. Methods Patient Population and Data Asse...

show abstract

mentioning

confidence: 99%

Intraoperative high-field MRI for transsphenoidal reoperations of nonfunctioning pituitary adenoma

Berkmann

Schlaffer

Nimsky

et al. 2014

JNS

View full text Add to dashboard Cite

show abstract

“…It is obvious that rendering of 3D Doppler US images and FE analysis were generally time-consuming tasks, but these can be improved using optimized algorithms. As compared to the conventional method of performing intraoperative MR imaging during operating time [27], which is very time-consuming, this method can be of great interest for neurosurgeons, particularly in terms of reducing surgery time.…”

Section: Discussionmentioning

confidence: 99%

Estimation of intraoperative brain shift by combination of stereovision and doppler ultrasound: phantom and animal model study

et al. 2015

View full text Add to dashboard Cite

The proposed projected surface imaging in conjunction with the Doppler US data combined in a powerful biomechanical model can result an acceptable performance in calculation of deformation during surgical navigation. However, the projected landmark method is sensitive to ambient light and surface conditions and the Doppler ultrasound suffers from noise and 3D image construction problems, the combination of these two methods applied on a FEM has an eligible performance.

show abstract

“…This duration is closely related to the ioMRI infrastructure and to the numbers and types of scanning sequences performed (e.g., whether or not an intravenous contrast agent is used). ioMRI has been associated with an increased duration of surgery of 1-4 h [3][4][5][6][7][8][9][10][11][12], but this could be decreased to 10-35 min [23,[27][28][29][30] with some compromises in surgical conditions and imaging protocol.…”

Section: Discussionmentioning

confidence: 99%

Intra-operative 3.0 T Magnetic Resonance Imaging Using a Dual-Independent Room: Long-Term Evaluation of Time-Cost, Problems, and Learning-Curve Effect

Martin

Vaz

Fomekong

et al. 2010

Intraoperative Imaging

View full text Add to dashboard Cite

We present a short and comprehensive report of our 39-month experience using a 3.0 T intra-operative magnetic resonance imaging (ioMRI) neurosurgical-MR twin room, including a description of the problems encountered and the associated time-delays. Forty-seven problems were experienced during the 189 ioMRI procedures (two ioMRI were performed in five of the 184 surgical procedures) performed in the 39-month period, including a blocked transfer table, failure of anesthetic monitoring material, and specific MRI-related problems, such as head and coil positioning difficulties, artefacts, coil malfunctions and other technical difficulties. None of these problems prevented the ioMRI procedure from taking place or affected image interpretation, but they sometimes caused a significant delay. Fifteen (32%) of these problems occurred during the initial learning curve period. The mean duration of the ioMRI procedure was 75 min, which decreased slightly with experience, although an average waiting-for-access time of 24 min could not be avoided. These results illustrate that although performing ioMRI at 3.0 T with the dual room is a challenging procedure, it remains safe and feasible and associated with only minor dysfunctions while offering optimal image quality and standard surgical conditions.

show abstract

Intraoperative MRI with a Rotating, Tiltable Surgical Table: A Time–Use Study and Clinical Results in 122 Patients

Cited by 28 publications

References 40 publications

Intraoperative high-field MRI for transsphenoidal reoperations of nonfunctioning pituitary adenoma

Intraoperative high-field MRI for transsphenoidal reoperations of nonfunctioning pituitary adenoma

Estimation of intraoperative brain shift by combination of stereovision and doppler ultrasound: phantom and animal model study

Intra-operative 3.0 T Magnetic Resonance Imaging Using a Dual-Independent Room: Long-Term Evaluation of Time-Cost, Problems, and Learning-Curve Effect

Contact Info

Product

Resources

About