Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience
BACKGROUND: Maximal safe resection is the objective of most neuro-oncological operations. Intraoperative magnetic resonance imaging (iMRI) may guide the surgeon to improve the extent of safe resection. There is limited evidence comparing the impact of iMRI on the rates of further resection between t...
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2025-01-01
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| author | Daniel Madani R. Dineth Fonseka Sihyong Jake Kim Patrick Tang Krishna Muralidharan Nicholas Chang Johnny Wong |
| author_facet | Daniel Madani R. Dineth Fonseka Sihyong Jake Kim Patrick Tang Krishna Muralidharan Nicholas Chang Johnny Wong |
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| description | BACKGROUND: Maximal safe resection is the objective of most neuro-oncological operations. Intraoperative magnetic resonance imaging (iMRI) may guide the surgeon to improve the extent of safe resection. There is limited evidence comparing the impact of iMRI on the rates of further resection between tumour types. AIM: To investigate the impact of iMRI on the rate of further resection following visualisation of residual tumour. METHODS: A retrospective cohort study identified all intracranial tumour operations performed in the 1.5 T iMRI machine of a single centre (2007–2023). Patients were identified using SurgiNet and were grouped according to their histopathological diagnosis in accordance with the WHO 2021 classification. The primary outcome was the rate of reoperation due to iMRI visualisation of residual tumours. RESULTS: A total of 574 cases were identified, including 152 low-grade gliomas (LGG), 108 high-grade gliomas (HGG), 194 pituitary neuroendocrine tumours (PitNETs), 15 metastases, and 6 meningiomas. Further resection following iMRI visualisation occurred in 45% of LGG cases, 47% of HGG cases, 29% of PitNET cases, and no meningioma or metastasis cases. Chi-square analysis showed that the rate of further resection after iMRI use across 2018–2023 was significantly higher than that across 2007–2012 (46% versus 33%, <i>p</i> = 0.036). CONCLUSION: Intraoperative MRI for guiding further resection was most useful in cases of LGG and HGG, possibly reflecting the difficulty of differentiating these tumour types from normal brain tissue. In addition, there was increased reliance on iMRI over time, which may represent our surgeons becoming accustomed to its use. |
| format | Article |
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| institution | Kabale University |
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| language | English |
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| series | Brain Sciences |
| spelling | doaj-art-ac6bdc0d7ca244258a7295512f5b6bc22025-01-24T13:25:47ZengMDPI AGBrain Sciences2076-34252025-01-011514510.3390/brainsci15010045Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre ExperienceDaniel Madani0R. Dineth Fonseka1Sihyong Jake Kim2Patrick Tang3Krishna Muralidharan4Nicholas Chang5Johnny Wong6Department of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaDepartment of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaDepartment of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaDepartment of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaDepartment of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaDepartment of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaDepartment of Neurosurgery, Royal Prince Alfred Hospital, Sydney 2050, AustraliaBACKGROUND: Maximal safe resection is the objective of most neuro-oncological operations. Intraoperative magnetic resonance imaging (iMRI) may guide the surgeon to improve the extent of safe resection. There is limited evidence comparing the impact of iMRI on the rates of further resection between tumour types. AIM: To investigate the impact of iMRI on the rate of further resection following visualisation of residual tumour. METHODS: A retrospective cohort study identified all intracranial tumour operations performed in the 1.5 T iMRI machine of a single centre (2007–2023). Patients were identified using SurgiNet and were grouped according to their histopathological diagnosis in accordance with the WHO 2021 classification. The primary outcome was the rate of reoperation due to iMRI visualisation of residual tumours. RESULTS: A total of 574 cases were identified, including 152 low-grade gliomas (LGG), 108 high-grade gliomas (HGG), 194 pituitary neuroendocrine tumours (PitNETs), 15 metastases, and 6 meningiomas. Further resection following iMRI visualisation occurred in 45% of LGG cases, 47% of HGG cases, 29% of PitNET cases, and no meningioma or metastasis cases. Chi-square analysis showed that the rate of further resection after iMRI use across 2018–2023 was significantly higher than that across 2007–2012 (46% versus 33%, <i>p</i> = 0.036). CONCLUSION: Intraoperative MRI for guiding further resection was most useful in cases of LGG and HGG, possibly reflecting the difficulty of differentiating these tumour types from normal brain tissue. In addition, there was increased reliance on iMRI over time, which may represent our surgeons becoming accustomed to its use.https://www.mdpi.com/2076-3425/15/1/45intraoperative imagingMRIbrain tumourglioma |
| spellingShingle | Daniel Madani R. Dineth Fonseka Sihyong Jake Kim Patrick Tang Krishna Muralidharan Nicholas Chang Johnny Wong Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience Brain Sciences intraoperative imaging MRI brain tumour glioma |
| title | Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience |
| title_full | Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience |
| title_fullStr | Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience |
| title_full_unstemmed | Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience |
| title_short | Comparing the Rates of Further Resection After Intraoperative MRI Visualisation of Residual Tumour Between Brain Tumour Subtypes: A 17-Year Single-Centre Experience |
| title_sort | comparing the rates of further resection after intraoperative mri visualisation of residual tumour between brain tumour subtypes a 17 year single centre experience |
| topic | intraoperative imaging MRI brain tumour glioma |
| url | https://www.mdpi.com/2076-3425/15/1/45 |
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