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Importance of intraoperative magnetic resonance imaging for pediatric brain tumor surgery.
MedLine Citation:
PMID:  22826818     Owner:  NLM     Status:  PubMed-not-MEDLINE    
BACKGROUND: High-field intraoperative MRI (IoMRI) is gaining increasing recognition as an invaluable tool in pediatric brain tumor surgery where the extent of tumor resection is a major prognostic factor. We report the initial experience of a dedicated pediatric 3-T intraoperative MRI (IoMRI) unit with integrated neuronavigation in the management of pediatric brain tumors.
METHODS: Seventy-three children (mean age 9.5 years; range 0.2-19 years) underwent IoMRI between October 2009 and January 2012, during 79 brain tumor resections using a 3-T MR scanner located adjacent to the neurosurgical operating theater that is equipped with neuronavigation facility. IoMRI was performed either to assess the extent of tumor resection after surgical impression of complete/intended tumor resection or to update neuronavigation. The surgical aims, IoMRI findings, extent of tumor resection, and follow-up data were reviewed.
RESULTS: Complete resection was intended in 47/79 (59%) operations. IoMRI confirmed complete resection in 27/47 (57%). IoMRI findings led to further resection in 12/47 (26%). In 7/47 (15%), IoMRI was equivocal for residual tumor and no evidence of residual tumor was found on re-inspection. In 32/79 (41%) operations, the surgical aim was partial tumor resection. In this subset, surgical resection was extended following IoMRI in 13/32 (41%) operations. None of the patients required early second look procedure for residual disease.
CONCLUSIONS: At our institution, IoMRI has led to increased rate of tumor resection and a change in surgical strategy with further tumor resection in 32% of patients. While interpreting IoMRI, it is important to be aware of the known pitfalls.
Jawad Yousaf; Shivaram Avula; Laurence J Abernethy; Conor L Mallucci
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Publication Detail:
Type:  Journal Article     Date:  2012-04-26
Journal Detail:
Title:  Surgical neurology international     Volume:  3     ISSN:  2152-7806     ISO Abbreviation:  Surg Neurol Int     Publication Date:  2012  
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-10-02     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101535836     Medline TA:  Surg Neurol Int     Country:  India    
Other Details:
Languages:  eng     Pagination:  S65-72     Citation Subset:  -    
Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom.
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