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Journal of Spine & NeurosurgeryISSN: 2325-9701

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Research Article, J Spine Neurosurg Vol: 4 Issue: 4

Optimization of Tumor Resection with Intra-operative Magnetic Resonance Imaging: A Comprehensive Review

Christian Swinney BA*, Anand Veeravagu MD, Amy Li BA and Inderpreet Bhatti BA
Department of Neurosurgery, Stanford University School of Medicine, CA, USA
Corresponding author : Christian Swinney
Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Dr., Stanford, CA 94305, USA
Tel: (650) 497-8000
E-mail: [email protected]
Received September 23, 2015 Accepted November 18, 2015 Published November 25, 2015
Citation: Christian Swinney BA, Anand Veeravagu MD, Amy Li BA, Inderpreet Bhatti BA (2015) MOptimization of Tumor Resection with Intra-operative Magnetic Resonance Imaging: A Comprehensive Review. J Spine Neurosurg 4:4. doi:10.4172/2325-9701.1000201

Abstract

Intra-operative MRI (ioMRI) may be used to optimize tumor resection. Utilization of this technology allows for the removal of residual tumor mass following initial tumor removal, maximizing the extent of resection. This, in turn, has been shown to lead to improved outcomes. Individual studies have examined the impact of ioMRI on the rate of extended resection, but a comprehensive review of this topic is needed. A literature review of the MEDLINE, EMBASE, CENTRAL, and Google Scholar databases revealed 12 eligible studies. This included 804 primary operations and 238 extended resections based on ioMRI findings. Use of ioMRI led to extended tumor resection in 13.3% - 54.8% of cases (mean 37.3%). Stratification by tumor type showed additional resection occurred, on average, in 39.1% of glioma resections (range 13.3%- 70.0%), 23.5% of pituitary tumor resections (range 13.3%-33.7%), and 35.0% of nonspecific tumor resections (range 17.5%-40%). Tumor type (glioma vs pituitary) did not significantly influence the rate of further excision following ioMRI (p=0.309). There was no difference in secondary resection rate between cases limited to pediatric patients and those including adults (p=0.646). Thus, the use of intra-operative MRI frequently results in further resection of primary tumors, minimizing residual tumor mass. It is primarily used for the resection of gliomas and pituitary tumors. Tumor type does not appear to be a significant contributing factor to the rate of secondary tumor removal. Extended resection may translate into improved clinical outcomes and mortality rates, improving the quality of patient care.

Keywords: Intra-operative MRI; ioMRI; Tumor resection; Intra-operative imaging; Resection optimization; Extent of resection; EOR

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