3-Tesla intraoperative MR imaging for neurosurgery

Area of Science:

• Neurosurgery
• Medical Imaging
• Magnetic Resonance Imaging

Background:

• Intraoperative magnetic resonance (MR) image-guided neurosurgery has been utilized since 1994.
• Over 750 interventional procedures have been performed using a 1.5-Tesla (T) intraoperative MR imaging system.
• The safety and efficacy of this technique are well-established for in-hospital MR suites.

Purpose of the Study:

• To adapt intraoperative MR image-guided neurosurgery to a new short-bore 3-T MR suite.
• To design and implement a surgical suite enabling procedures entirely within a 3-T MR environment.
• To evaluate the safety and efficacy of neurosurgery at 3-T.

Main Methods:

• All surgical instrumentation, including electrocautery and ultrasonic aspirators, was made MR-compatible.
• Procedures were performed within a 3-T MR environment with strict precautions for minimally ferromagnetic items.
• Cases included drainage and reservoir placement, brain biopsies, and craniotomies for biopsy and resection.

Main Results:

• A cystic craniopharyngioma was successfully treated with aspiration and reservoir placement.
• All five brain biopsies yielded diagnostic tissue.
• Craniotomy for mass resection revealed radiation necrosis; image interpretation was accurate despite increased metallic artifact at 3-T.

Conclusions:

• MR-guided neurosurgery can be safely and effectively performed at 3-T.
• The 3-T surgical environment is comparable to the 1.5-T environment for neurosurgical procedures.
• No adverse events were associated with any procedures performed at 3-T.