gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Impact of intraoperative high-field MRI and functional neuronavigation on supratentorial glioma resection

Einfluss der intraoperativen Hochfeld-MR-Bildgebung und der funktionellen Neuronavigation auf die Resektion von supratentoriellen Gliomen

Meeting Abstract

  • corresponding author D. Weigel - Klinik für Neurochirurgie, Universität Erlangen-Nürnberg, Erlangen
  • O. Ganslandt - Klinik für Neurochirurgie, Universität Erlangen-Nürnberg, Erlangen
  • B. v. Keller - Klinik für Neurochirurgie, Universität Erlangen-Nürnberg, Erlangen
  • R. Fahlbusch - Klinik für Neurochirurgie, Universität Erlangen-Nürnberg, Erlangen
  • M. Buchfelder - Klinik für Neurochirurgie, Universität Erlangen-Nürnberg, Erlangen
  • C. Nimsky - Klinik für Neurochirurgie, Universität Erlangen-Nürnberg, Erlangen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.03.02

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Weigel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: To investigate how functional neuronavigation and intraoperative high-field magnetic resonance imaging (MRI) influence glioma resection.

Methods: 137 patients (WHO grade I: 20; II: 19; III: 41; IV: 57) underwent resection for supratentorial gliomas in an operative suite equipped with an intraoperative high-field MRI and microscope-based neuronavigation. Besides standard anatomical image data including T1- and T2-weighted sequences, various functional data from magnetoencephalography (n=37), functional MRI (n=65), positron emission tomography (n=8), MR spectroscopy (n=28) and diffusion tensor imaging (n=55) were integrated in the navigational setup.

Results: Intraoperative MRI showed primary complete resection in 27% of all patients (I: 50%; II: 53%; III: 2%; IV: 28%). In 41% of all patients (I: 40%; II: 26%; III: 66%; IV: 28%) the resection was extended due to intraoperative MRI increasing the percentage of complete resections to 40% (I: 70%; II: 58%; III: 17%; IV: 40%). Integrated application of functional navigation resulted in low postoperative morbidity with a transient new neurological deficit in 10.2% (paresis: 8.8%, speech disturbance: 1.4%) decreasing to a permanent deficit in 2.9% (4 of 137 patients with a new or worsened paresis).

Conclusions: The combination of intraoperative MRI and functional navigation allows safe extended resections in glioma surgery. However, despite extended resections, in the majority of the grade III and IV gliomas, still no gross total resection could be achieved due to the extension of the tumor into eloquent brain areas. Intraoperative MRI data can be used to localize the tumor remnants reliably and compensate for the effects of brain shift.