gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Optimized extent of resection in glioma surgery with the intraoperative MRI system PoleStar N10

Optimierung des Resektionsausmaßes in der Gliomchirurgie mit dem intraoperativen MRT PoleStar N10

Meeting Abstract

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  • corresponding author H. Müller - Klinikum Augsburg, Neurochirurgische Klinik, Augsburg
  • S. Bader - Klinikum Augsburg, Neurochirurgische Klinik, Augsburg
  • V. Heidecke - Klinikum Augsburg, Neurochirurgische Klinik, Augsburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.09.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc190.shtml

Veröffentlicht: 11. April 2007

© 2007 Müller et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: To demonstrate the advantages of using an intraoperative low-field MRI-system in respect to the extent of resection.

Methods: Intraoperative low-field MRI in supratentorial glioma surgery was performed by using the PoleStar system N10 in 82 cases (56 glioblastomas, 20 anaplastic astrocytomas and 6 low-grade gliomas). The operating table was shielded by a so-called Starshield tent. Special interest was centered on residual tumor and the impact of the images on the surgeon’s decision to continue surgery.

Results: In 24 cases (29,3%) residual tumor was detected even though the surgeon estimated the tumor to be totally removed. Surgery was continued in 22 cases. In the other two cases residual tumor was left because it was too close to eloquent regions. There were no complications attributed to the use of the iMRI system. Outcome was good or fair in 72 patients (87,8%), 4 patients (4,9%) did not completely recover from aphasia or hemiparesis and 6 patients (7,3%) had additional neurological deficits when leaving the hospital. Final intraoperative imaging was compared with early postoperative MRI in a 1,5 Tesla machine and revealed little residual tumor in two cases which had not been clearly displayed in the intraoperative low-field MRI.

Conclusions: Intraoperative low-field MRI offers the possilility of detecting residual tumor in glioma surgery in approximately one third of all cases even for experienced surgeons. By updating the integrated navigation system, surgery can be performed more precisely. The system helps to achieve complete tumor removal.