title: High field strength magnetic resonance imaging in paediatric brain tumour surgery--its role in prevention of early repeat resections.
abstract: OBJECTIVE
  The purpose of this study is to compare the surgical and imaging outcome in children who underwent brain tumour surgery with intention of complete tumour resection, prior to and following the start of intra-operative MRI (ioMRI) service.
  
  
  METHODS
  ioMRI service for brain tumour resection commenced in October 2009. A cohort of patients operated between June 2007 and September 2009 with a pre-surgical intention of complete tumour resection were selected (Group A). A similar number of consecutive cases were selected from a prospective database of patients undergoing ioMRI (Group B). The demographics, imaging, pathology and surgical outcome of both groups were compared.
  
  
  RESULTS
  Thirty-six of 47 cases from Group A met the inclusion criterion and 36 cases were selected from Group B; 7 of the 36 cases in Group A had unequivocal evidence of residual tumour on the post-operative scan; 5 (14%) of them underwent repeat resection within 6 months post-surgery. In Group B, ioMRI revealed unequivocal evidence of residual tumour in 11 of the 36 cases following initial resection. In 10 of these 11 cases, repeat resections were performed during the same surgical episode and none of these 11 cases required repeat surgery in the following 6 months. Early repeat resection rate was significantly different between both groups (p = 0.003).
  
  
  CONCLUSIONS
  Following the advent of ioMRI at our institution, the need for repeat resection within 6 months has been prevented in cases where ioMRI revealed unequivocal evidence of residual tumour.
authors.affiliation: Department of Radiology, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK, shivaram.avula@alderhey.nhs.uk.
authors.forename: Shivaram
authors.initials: S
authors.lastname: Avula
authors.forename: Benedetta
authors.initials: B
authors.lastname: Pettorini
authors.forename: Laurence
authors.initials: L
authors.lastname: Abernethy
authors.forename: Barry
authors.initials: B
authors.lastname: Pizer
authors.forename: Dawn
authors.initials: D
authors.lastname: Williams
authors.forename: Conor
authors.initials: C
authors.lastname: Mallucci
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D055502:Secondary Prevention; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome