Usefulness of Intraoperative Ultra Low-field Magnetic Resonance Imaging in Glioma Surgery

2008 ◽  
Vol 63 (suppl_4) ◽  
pp. ONS257-ONS267 ◽  
Author(s):  
Christian Senft ◽  
Volker Seifert ◽  
Elvis Hermann ◽  
Kea Franz ◽  
Thomas Gasser
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tumor Resection ◽  
Extent Of Resection ◽  
Resonance Imaging ◽  
Complete Tumor Resection ◽  
Glioma Surgery ◽  
Low Field ◽  
Low Field Mri ◽  
Complete Tumor

Abstract Objective: The aim of this study was to demonstrate the usefulness of a mobile, intraoperative 0.15-T magnetic resonance imaging (MRI) scanner in glioma surgery. Methods: We analyzed our prospectively collected database of patients with glial tumors who underwent tumor resection with the use of an intraoperative ultra low-field MRI scanner (PoleStar N-20; Odin Medical Technologies, Yokneam, Israel/Medtronic, Louisville, CO). Sixty-three patients with World Health Organization Grade II to IV tumors were included in the study. All patients were subjected to postoperative 1.5-T imaging to confirm the extent of resection. Results: Intraoperative image quality was sufficient for navigation and resection control in both high-and low-grade tumors. Primarily enhancing tumors were best detected on T1-weighted imaging, whereas fluid-attenuated inversion recovery sequences proved best for nonenhancing tumors. Intraoperative resection control led to further tumor resection in 12 (28.6%) of 42 patients with contrast-enhancing tumors and in 10(47.6%) of 21 patients with noncontrast-enhancing tumors. In contrast-enhancing tumors, further resection led to an increased rate of complete tumor resection (71.2 versus 52.4%), and the surgical goal of gross total removal or subtotal resection was achieved in all cases (100.0%). In patients with noncontrast-enhancing tumors, the surgical goal was achieved in 19 (90.5%) of 21 cases, as intraoperative MRI findings were inconsistent with postoperative high-field imaging in 2 cases. Conclusion: The use of the PoleStar N-20 intraoperative ultra low-field MRI scanner helps to evaluate the extent of resection in glioma surgery. Further tumor resection after intraoperative scanning leads to an increased rate of complete tumor resection, especially in patients with contrast-enhancing tumors. However, in noncontrast-enhancing tumors, the intraoperative visualization of a complete resection seems less specific, when compared with postoperative 1.5-T MRI.

Quantification of Glioma Removal by Intraoperative High-Field Magnetic Resonance Imaging: An Update

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. 852-863 ◽  
Author(s):  
Daniela Kuhnt ◽  
Oliver Ganslandt ◽  
Sven-Martin Schlaffer ◽  
Michael Buchfelder ◽  
Christopher Nimsky
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Field ◽  
Tumor Volume ◽  
Tumor Resection ◽  
World Health ◽  
Incomplete Resection ◽  
Resonance Imaging ◽  
Glioma Surgery ◽  
Who Grade

Abstract BACKGROUND: The beneficial role of the extent of resection (EOR) in glioma surgery in correlation to increased survival remains controversial. However, common literature favors maximum EOR with preservation of neurological function, which is shown to be associated with a significantly improved outcome. OBJECTIVE: In order to obtain a maximum EOR, it was examined whether high-field intraoperative magnetic resonance imaging (iMRI) combined with multimodal navigation contributes to a significantly improved EOR in glioma surgery. METHODS: Two hundred ninety-three glioma patients underwent craniotomy and tumor resection with the aid of intraoperative 1.5 T MRI and integrated multimodal navigation. In cases of remnant tumor, an update of navigation was performed with intraoperative images. Tumor volume was quantified pre- and intraoperatively by segmentation of T2 abnormality in low-grade and contrast enhancement in high-grade gliomas. RESULTS: In 25.9% of all cases examined, additional tumor mass was removed as a result of iMRI. This led to complete tumor resection in 20 cases, increasing the rate of gross-total removal from 31.7% to 38.6%. In 56 patients, additional but incomplete resection was performed because of the close location to eloquent brain areas. Volumetric analysis showed a significantly (P < .01) reduced mean percentage of tumor volume following additional further resection after iMRI from 33.5% ± 25.1% to 14.7% ± 23.3% (World Health Organization [WHO] grade I, 32.8% ± 21.9% to 6.1% ± 18.8%; WHO grade II, 24.4% ± 25.1% to 10.8% ± 11.0%; WHO grade III, 35.1% ± 27.3% to 24.8% ± 26.3%; WHO grade IV, 34.2% ± 23.7% to 1.2% ± 16.2%). CONCLUSION: MRI in conjunction with multimodal navigation and an intraoperative updating procedure enlarges tumor-volume reduction in glioma surgery significantly without higher postoperative morbidity.

Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy

2015 ◽  
Vol 43 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Marie Feletar ◽  
Stephen Hall ◽  
Paul Bird
Keyword(s):  
Magnetic Resonance Imaging ◽  
Psoriatic Arthritis ◽  
Magnetic Resonance ◽  
High Field ◽  
Early Response ◽  
Resonance Imaging ◽  
Low Field ◽  
Low Field Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Necrosis Factor

Objective.To assess the responsiveness of high- and low-field extremity magnetic resonance imaging (MRI) variables at multiple timepoints in the first 12 weeks post-antitumor necrosis factor (anti-TNF) therapy initiation in patients with psoriatic arthritis (PsA) and active dactylitis.Methods.Twelve patients with active PsA and clinical evidence of dactylitis involving at least 1 digit were recruited. Patients underwent sequential high-field conventional (1.5 Tesla) and extremity low-field MRI (0.2 Tesla) of the affected hand or foot, pre- and postgadolinium at baseline (pre-TNF), 2 weeks (post-TNF), 6 weeks, and 12 weeks. A blinded observer scored all images on 2 occasions using the PsA MRI scoring system.Results.Eleven patients completed the study, but only 6 patients completed all high-field and low-field MRI assessments. MRI scores demonstrated rapid response to TNF inhibition with score reduction in tenosynovitis, synovitis, and osteitis at 2 weeks. Intraobserver reliability was good to excellent for all variables. High-field MRI demonstrated greater sensitivity to tenosynovitis, synovitis, and osteitis and greater responsiveness to change posttreatment. Treatment responses were maintained to 12 weeks.Conclusion.This study demonstrates the use of MRI in detecting early response to biologic therapy. MRI variables of tenosynovitis, synovitis, and osteitis demonstrated responsiveness posttherapy with high-field scores more responsive to change than low-field scores.

scholarly journals Inflammatory and post-inflammatory lesions in the sacroiliac joints and lumbar spine according to magnetic resonance imaging in patients with early axial spondyloarthritis

2019 ◽  
Vol 57 (1) ◽  
pp. 28-32 ◽  
Author(s):  
D. G. Rumyantseva ◽  
Sh. Erdes ◽  
A. V. Smirnov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Disease Duration ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Low Field ◽  
Low Field Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Inflammatory Changes

Investigation of the evolution of early axial spondylitis (axSP) is now of great importance especially before the appearance of reliable radiological signs of ankylosing spondylitis (AS). Of particular interest is the assessment of inflammatory and post-inflammatory changes in the sacroiliac joints (SJ) and in the spine using magnetic resonance imaging (MRI).The aimof the study was to analyze inflammatory foci in bone according to MRI in the area of SJ and lumbar spine (LS) in patients with early axSP.Material and methods.The study involved the patients of the Moscow cohort CORSAIR (Early Spondyloarthritis Cohort), which was formed in V.A. Nasonova Research Institute of Rheumatology. Low field MRI of SJ and LS was carried out in all patients at inclusion in the study in the T1 and STIR modes.Results and discussion.SJ MRI most often (34.1%) revealed combined foci of inflammation (active and chronic sacroiliitis – SI), 32.9% of patients showed signs of only chronic, rarely – only active SI (19.5%). In a few cases, MRI showed inflammatory changes in LS, which were regarded as active and chronic spondylitis. In patients with a disease duration of up to 1 year, signs of active SI were more common according to MRI than in patients with a longer duration of the disease (30.0 and 14.4%, respectively; p<0.05). All active foci of inflammation (with or without signs of chronic SI) were significantly more frequently detected in patients with AS than in non-radiological axSP (NR-axSP; 61.6% and 44.2%, respectively; p<0.05). The overall incidence of chronic spondylitis (in combination with or without active spondylitis) in patients with AS was higher than in NR-axSP(13.9% and 5.8%, respectively; p<0.05).Conclusion.Patients with AS more often have active lesions at MRI of SJ and chronic ones at MRI of LS than patients with NR-axSP

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