Optimizing brain tumor resection. High-field interventional MR imaging.
High-field strength iMRI guidance is an effective tool for brain tumor resection. Although its use lengthens the average time for a craniotomy, the reward is a more extensive tumor excision compared with conventional neurosurgery without an increased risk to the patient (Table 4). Although intraoperative patient transfer into and out of the magnet is cumbersome, the possibility for complete resection, especially for a low-grade glioma, makes the effort worthwhile. The cost and technical support required for this system presently limits its use to only a few sites worldwide. As with any technology, further refinements will make this system less expensive and more attainable. Practical consideration aside, high-field strength iMRI is presently [table: see text] the most effective tool available for brain tumor resection. Because of its novelty, future studies are necessary to determine if this technology lowers the incidence of and extends the duration to tumor recurrence as the preliminary data in children suggests. These are the ultimate measures of efficacy for any brain tumor treatment. Based on the rapid advancement of technology, will today's high-field strength interventional magnet become tomorrow's low-field system? Very high-field strength designs may improve diagnostic capabilities through higher resolution, but their interventional applications may be hindered by increased sensitivity for clinically insignificant abnormalities and decreased specificity for clinically relevant lesions. As new technology is developed, clinicians must continue to explore and refine the existing high-field strength iMRI to make it cost-effective and widely applicable.
Tummala
R P
RP
Department of Neurosurgery, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
Chu
R M
RM
Liu
H
H
Truwit
C L
CL
Hall
W A
WA
D000293:Adolescent; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D025321:Surgery, Computer-Assisted