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Intelligent operating theater using intraoperative open-MRI
Hiroshi Iseki1, Yoshihiro Muragaki, Ryoichi Nakamura
1Faculty of Advanced Technosurgery, Division of Advanced Biomedical Engineering & Science, Graduate School of Medicine, Institute of Advanced Biomedical Engineering & Science, Tokyo Women's Medical University, Japan. hiseki@abmes.twmu.ac.jp
Summary
Intraoperative magnetic resonance (MR) imaging enhances malignant brain tumor surgery by providing real-time visualization. This allows surgeons to precisely resect tumors near critical brain areas, improving patient outcomes and reducing neurological deficits.
Area of Science:
- Neurosurgery
- Medical Imaging
- Oncology
Background:
- Malignant brain tumors present challenges due to variability in shape, infiltration, and patient-specific functional brain area localization.
- Damage to eloquent areas during tumor resection can lead to motor paresis and speech disturbances.
- Traditional neurosurgery relied on speculation, with outcomes only confirmed postoperatively.
Purpose of the Study:
- To highlight the transformative impact of intraoperative magnetic resonance (MR) imaging on malignant brain tumor surgery.
- To demonstrate how intraoperative MR imaging improves surgical precision and safety.
- To explain how advanced MR techniques aid in preserving neurological function.
Main Methods:
- Utilizing intraoperative MR imaging, including diffusion-tensor and diffusion-weighted imaging, during neurosurgical procedures.
- Employing various open and bore-type MR scanners (0.2T to 1.5T, with 3.0T planned) in the operating theater.
- Leveraging intraoperative MR images for surgical navigation to overcome challenges like brain shift.
Main Results:
- Intraoperative MR imaging provides real-time visualization of residual tumor size and its relationship to eloquent areas.
- Brain shift, a previous limitation, is effectively managed with intraoperative MR imaging for precise surgical navigation.
- Diffusion-tensor and diffusion-weighted imaging enable visualization of white matter tracts, such as the pyramidal tract.
Conclusions:
- Intraoperative MR imaging significantly enhances the safety and reliability of malignant brain tumor resection.
- Precise resection near eloquent areas is achievable, minimizing the risk of neurological damage.
- Advanced intraoperative MR techniques are crucial for preserving motor function during complex tumor surgeries.