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Intraoperative dynamic susceptibility contrast MRI (iDSC-MRI) is as reliable as preoperatively acquired perfusion

Stephan Ulmer1, Gesa Hartwigsen, Christian Riedel

  • 1Institute of Neuroradiology University Hospital of Schleswig-Holstein, Campus Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany. ulmer@email.com

Neuroimage
|November 11, 2009
PubMed

Insights

Intraoperative dynamic susceptibility contrast MRI (DSC-MRI) accurately assesses brain tumor resection. This method provides reliable, up-to-date information during surgery, aiding in the detection of residual tumor tissue.

Area of Science:

  • Neurosurgery
  • Radiology
  • Medical Imaging

Background:

  • Accurate assessment of tumor resection is critical for patient outcomes.
  • Intraoperative imaging can help identify residual tumor burden.
  • Brain shift and surgical artifacts can complicate intraoperative assessments.

Purpose of the Study:

  • To evaluate the reliability of intraoperative dynamic susceptibility contrast MRI (iDSC-MRI) during human brain tumor removal.
  • To compare iDSC-MRI data with preoperatively acquired DSC-MRI data.
  • To assess the utility of iDSC-MRI in detecting residual tumor tissue.

Main Methods:

  • DSC-MRI was performed intraoperatively on 30 patients undergoing brain tumor removal.
  • Relative regional blood flow (rCBF), blood volume (rCBV), and mean transit time (MTT) maps were calculated.
  • Intraoperative data ratios were compared to preoperative DSC-MRI and postoperative MRI findings.

Main Results:

  • iDSC-MRI successfully depicted residual tumor tissue in 8 patients.
  • Ratios for rCBV and rCBF showed no significant difference between pre- and intraoperative data.
  • High correlations were found between pre- and intraoperative rCBV and rCBF ratios (r²=0.86 for both).

Conclusions:

  • Intraoperative DSC-MRI is a reliable tool for assessing brain tumor resection.
  • iDSC-MRI provides current pathophysiologic information, independent of brain shift and surgical artifacts.
  • This technique can assist in identifying residual tumor burden beyond conventional imaging methods.

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