Preoperative magnetic resonance imaging protocol for endoscopic cranial base image-guided surgery

Area of Science:

• Neurosurgery
• Radiology
• Medical Imaging

Background:

• Image-guided surgery (IGS) is increasingly used, but lacks standardized radiology protocols for optimal magnetic resonance (MR) imaging quality.
• Over 300 endonasal cranial base procedures were performed at the institution in 3 years, highlighting the need for efficient preoperative imaging.

Purpose of the Study:

• To develop a standardized MR imaging protocol for skull base procedures to optimize preoperative evaluation and intraoperative guidance.
• To create diagnostic-quality images for common pathologies, improving workflow and reducing costs associated with custom MR studies.

Main Methods:

• A retrospective technical assessment was conducted.
• A collaborative effort between otolaryngology, neurosurgery, and neuroradiology departments developed the protocol.

Main Results:

• The developed skull base MR imaging protocol provides thin-cut precontrast and postcontrast axial images for intraoperative planning.
• It includes a thin-cut T2 axial series for intraoperative use or fusion with CT scans.
• The protocol yields effective T1 and T2 sequences for both diagnostic and operative purposes in IGS.

Conclusions:

• A novel, standardized MR imaging protocol for image-guided skull base surgery has been successfully implemented.
• This protocol enhances diagnostic image quality, streamlines workflow, and supports precise intraoperative navigation.