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Updated: Jul 11, 2025
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
The impact of intraoperative MRI on cranial surgical site infections-a single-center analysis
Ann-Kathrin Joerger1, Xhimi Laho1, Victoria Kehl2
1Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany.
Purpose:
The use of intraoperative MRI (ioMRI) contributes to an improved extent of resection. Hybrid operating room MRI suites have been established, with the patient being transferred to the MRI scanner. In the present descriptive analysis, we compared the rate of surgical site infections (SSI) after intracranial tumor surgery with and without the use of ioMRI.
Methods:
In this retrospective study, we included 446 patients with open craniotomy performed for brain tumor surgery. One hundred fourteen patients were operated on with the use of ioMRI between June 1, 2018, and June 30, 2019 (group 1). During the same period, 126 patients were operated on without ioMRI (group 2). As an additional control group, we analyzed 206 patients operated on from February 1, 2017, to February 28, 2018 when ioMRI had not yet been implemented (group 3).
Results:
The rate of SSI in group 1 (11.4%), group 2 (9.5%), and group 3 (6.8%) did not differ significantly (p = 0.352). Additional resection after ioMRI did not result in a significantly elevated number of SSI. No significant influence of re-resection, prior radio-/chemotherapy, blood loss or duration of surgery was found on the incidence of SSI.
Conclusion:
Despite the transfer to a non-sterile MRI scanner, leading to a prolonged operation time, SSI rates with and without the use of ioMRI did not differ significantly. Hence, advantages of ioMRI outweigh potential disadvantages as confirmed by this real-life single-center study.
Insights
Intraoperative MRI (ioMRI) in brain tumor surgery did not increase surgical site infections (SSI) despite longer operation times. This study found ioMRI safe, with infection rates comparable to traditional methods.
Area of Science:
- Neurosurgery
- Medical Imaging
- Infection Control
Background:
- Intraoperative MRI (ioMRI) is increasingly used to improve tumor resection extent.
- Hybrid operating room MRI suites involve patient transfer to the scanner.
- The impact of ioMRI on surgical site infections (SSI) requires investigation.
Purpose of the Study:
- To compare SSI rates in intracranial tumor surgery with and without ioMRI.
- To evaluate the safety of ioMRI regarding infection risk.
- To assess the influence of ioMRI on surgical outcomes.
Main Methods:
- Retrospective analysis of 446 patients undergoing craniotomy for brain tumor surgery.
- Comparison of SSI rates across three groups: with ioMRI (n=114), without ioMRI (n=126), and pre-ioMRI implementation (n=206).
- Data collected between February 2017 and June 2019 at a single center.
Main Results:
- SSI rates were 11.4% (ioMRI), 9.5% (without ioMRI), and 6.8% (pre-ioMRI).
- No statistically significant difference in SSI rates was observed between groups (p = 0.352).
- Factors like re-resection, prior therapy, blood loss, or surgery duration did not significantly impact SSI incidence.
Conclusions:
- Transferring patients to MRI scanners for ioMRI does not significantly increase SSI risk.
- The benefits of ioMRI in improving resection extent appear to outweigh potential infection risks.
- This single-center study confirms the safety of ioMRI in a real-world setting.
