Abstract
Objective: The impact of intraoperative MRI (iMRI) on the surgical procedure, patient outcome
and median survival for a series of patients harbouring high-grade gliomas forms the
basis of this study. Their outcome has been compared to a matched cohort of patients
operated in a conventional manner to determine if the use of intraoperative MRI can
be shown to improve the results of surgery and prognosis for this type of patient.
Materials and Methods: 32 microsurgical open craniotomies, performed in the intraoperative iMRI scanner
for grade IV supratentorial gliomas, with follow-up periods of more than 2 months,
were analyzed for this study. A group of 32 primary high-grade glioma patients (no
recurrent tumors) were matched for age, preoperative clinical grade, gender and histology
and operated during a corresponding time interval in a conventional manner acted as
controls. Results: All 64 patients were examined and analyzed for the occurrence of postoperative increased
neurological morbidity or death. No complications directly related to the intraoperative
scanning procedures were observed and no intraoperative death occurred in either group.
The average operating time in the intraoperative scanner was 5.1 hours and was significantly
longer than in the conventional OR (3.4 hours). The mean overall survival time for
the 32 patients in the study group was 14.5 months (95 % confidence interval 12.0
- 16.6) compared to 12.1 months (95 % confidence interval 10.2 - 14.1) for the matched
control group. Conclusion: Although iMRI is an effective way of imaging residual tumor, this study could not
demonstrate an increased efficacy of surgery utilizing this technique for patients
harbouring grade IV gliomas compared to more conventional methods. No statistical
significance was noted between the two groups (p = 0.14). The complication rate was
within the range reported for other series, in both control as well as the study group.
Key words
Glioma - MRI - intraoperative imaging - neuronavigation
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Henry Hirschberg, M. D., Ph. D.
Department of Neurosurgery · Rikshospitalet
0027 Oslo
Norway ·
Telefon: +47-230-74323
eMail: hirschberg@laser.bli.uci.edu
