Introduction: Intraoperative MRI examination (iMRI) in glioma surgery can increase the extent of resection and it also helps to achieve radical resection in more cases.
Methods: : Patients undergoing the glioma surgery with iMRI were prospectively followed in this study. During the glioma surgery iMRI (3T) was performed based on surgeon´s request. The radical resection was achieved if no residual tumor was detected on T2 (LGG) or postcontrast T1 (HGG) images. The images were analyzed by independent neuroradiologist.
Results: From April 2008 to October 2013 405 glioma patients underwent surgery with intraoperative MR examination (biopsies were excluded). In group of intended partial resection (PR) (195 cases) in 67 cases resection continued after the first MR. In 24 of PR cases radical resection (RR) was achieved. In group of 210 cases, where RR was planned, resection continued because of residual tumor in 93 patients after MR examination and RR was achieved in 68 of them. In the remaining 117 cases the procedure was stopped after MR examination. In this group RR was achieved in 111 patients. Probable tumor remnant was suspected according to iMRI in 12 patients, but it was decided not to continue with the surgery. Residual tumour was confirmed on postop. MR in 6 cases. In 160 cases iMRI helped to detect the tumor remnant and to extent the resection, in these 76 patients RR was achieved.
Conclusions: Intraoperative MR examination increases possibility to achieve radical resection in glioma patients.
Supported by IGA NT 13212 and P27/LF1/7
Patient Care: Intraoperative MRI examination increases extent of resection and helps to achieve radical resection in glioma surgery
Learning Objectives: Importance of intraoperative MRI examination in glioma surgery