Identification of disappearing brain lesions with intraoperative magnetic resonance imaging prevents surgery.
BACKGROUND
Typically, neurosurgery is performed several weeks after diagnostic imaging. In the majority of cases, histopathology confirms the diagnosis of neoplasia. In a small number of cases, a different diagnosis is established or histopathology is nondiagnostic. The frequency with which these outcomes occur has not been established.


OBJECTIVE
To determine the frequency and outcome of disappearing brain lesions within a group of patients undergoing surgery for suspected brain tumor.


METHODS
Over the past decade, 982 patients were managed in the intraoperative magnetic resonance imaging unit at the University of Calgary, Calgary, Alberta, Canada. These patients have been prospectively evaluated.


RESULTS
In 652 patients, a brain tumor was suspected. In 6 of the 652 patients, histopathology indicated a nontumor diagnosis. In 5 patients, intraoperative images, acquired after induction of anesthesia, showed complete or nearly complete resolution of the suspected tumor identified on diagnostic magnetic resonance imaging acquired 6 ± 4 (mean ± SD) weeks previously. Anesthesia was reversed, and the surgical procedure aborted. The lesions have not progressed with 6 ± 2 years of follow-up.


CONCLUSIONS
Intraoperative magnetic resonance imaging prevented surgery on 5 patients with disappearing lesions.
Sutherland
Christina S
CS
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Kelly
John Jp
JJ
Morrish
William
W
Sutherland
Garnette R
GR
D000328:Adult; D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D009493:Neurosurgery / Q000379:methods*; D012189:Retrospective Studies