Article
Intraoperative MRI with the PoleStar N10 in glioma surgery: outcome analysis and evaluation of tumour resection grade in 20 cases
Intraoperative Kernspintomographie mit dem PoleStar N10 in der Gliomchirurgie: Analyse von Outcome und Resektionsgrad bei 20 Patienten
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Published: | May 4, 2005 |
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Outline
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Objective
This study was undertaken to evaluate the extent of resection and the neurological outcome of 20 surgically treated patients with supratentorial glioma. The advantages will be pointed out as well as the pitfalls.
Methods
20 patients with supratentorial glioma underwent surgical treatment with the PoleStar N10 system. Age ranged from 27 to 69 years (mean 48.5 years). All patients had a pre- and postoperative MRI scan with a 1.5-Tesla Siemens Magnetom. We compared the intraoperative imaging of the PoleStar MRI with the images of the 1.5 Tesla machine. Neurological outcome was evaluated one week after the operation and after three months. Patients were classified according to the NIH stroke score and the Karnofsky index.
Results
In 95% of the cases, the early postoperative 1.5 Tesla imaging showed the same extent of tumour resection in comparison to the final intraoperative scans with the PoleStar N10. In 80% a complete tumour resection could be achieved. In 3 cases (15%) there was tumour infiltration of the corpus callosum which lead to subtotal resection. In 95% of all cases the intraoperative imaging revealed residual tumour and lead to enlargement of the resection. Image quality was excellent in 6 cases, sufficient in 13 cases and poor in 1 case because of artefacts.
There was no mortality and no severe complications. In 50% of the cases the postoperative neurological score did not change. In 20% neurological deficits improved. 30% of the patients had moderate additional deficits after operation due to the localisation of the tumour in an eloquent area. The mean preoperative Karnofsky score was 84%, one week after the operation the mean score decreased mildly to 73%.
Conclusions
The PoleStar N10 is an appropriate tool to improve the extent of tumour resection. Image quality was sufficient for surgical demands in 95% of the cases and revealed zones of residual tumour by intraoperative scanning in all of these patients.