Intraoperative MRI without an intraoperative MRI suite: a workflow for glial tumor surgery

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Intraoperative MRI without an intraoperative MRI suite : a workflow for glial tumor surgery

Frisk, Henrik (author): Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

Persson, Oscar (author): Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden

Fagerlund, Michael (author): Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden

Jensdottir, Margret (author): Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden

El-Hajj, Victor Gabriel (author): Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

Burström, Gustav (author): Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden

Sunesson, Annika (author): Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden

Kits, Annika (author): Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden

Majing, Tomas (author): Department of Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden

Edström, Erik, 1975- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden; Capio Spine Center Stockholm, Löwenströmska Hospital, Stockholm, Sweden; Department of Medical Sciences, Örebro University, Örebro, Sweden

Kaijser, Magnus (author): Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska University Hospital, Stockholm, Sweden

Elmi-Terander, Adrian, 1971- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden; Capio Spine Center Stockholm, Löwenströmska Hospital, Stockholm, Sweden; Department of Medical Sciences, Örebro University, Örebro, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden

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Springer, 2024
2024
English.
In: Acta Neurochirurgica. - : Springer. - 0001-6268 .- 0942-0940. ; 166:1

Related links:: https://doi.org/10.1...; show more...; https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: Intraoperative MRI (iMRI) has emerged as a useful tool in glioma surgery to safely improve the extent of resection. However, iMRI requires a dedicated operating room (OR) with an integrated MRI scanner solely for this purpose. Due to physical or economical restraints, this may not be feasible in all centers. The aim of this study was to investigate the feasibility of using a non-dedicated MRI scanner at the radiology department for iMRI and to describe the workflow with special focus on time expenditure and surgical implications.METHODS: In total, 24 patients undergoing glioma surgery were included. When the resection was deemed completed, the wound was temporarily closed, and the patient, under general anesthesia, was transferred to the radiology department for iMRI, which was performed using a dedicated protocol on 1.5 or 3 T scanners. After performing iMRI the patient was returned to the OR for additional tumor resection or final wound closure. All procedural times, timestamps, and adverse events were recorded.RESULT: The median time from the decision to initiate iMRI until reopening of the wound after scanning was 68 (52-104) minutes. Residual tumors were found on iMRI in 13 patients (54%). There were no adverse events during the surgeries, transfers, transportations, or iMRI-examinations. There were no wound-related complications or infections in the postoperative period or at follow-up. There were no readmissions within 30 or 90 days due to any complication.CONCLUSION: Performing intraoperative MRI using an MRI located outside the OR department was feasible and safe with no adverse events. It did not require more time than previously reported data for dedicated iMRI scanners. This could be a viable alternative in centers without access to a dedicated iMRI suite.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

Glioma surgery
Intraoperative MRI
Workflow

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By the author/editor: Frisk, Henrik; Persson, Oscar; Fagerlund, Micha ...; Jensdottir, Marg ...; El-Hajj, Victor ...; Burström, Gustav; show more...; Sunesson, Annika; Kits, Annika; Majing, Tomas; Edström, Erik, 1 ...; Kaijser, Magnus; Elmi-Terander, A ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

Articles in the publication: Acta Neurochirur ...

By the university: Örebro University

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