title: A Preliminary Experience with Use of Intraoperative Magnetic Resonance Imaging in Thalamic Glioma Surgery: A Case Series of 38 Patients.
abstract: Thalamic gliomas are rare tumors that constitute 1%-5% of all central nervous system tumors. Despite advanced techniques and equipment, surgical resection remains challenging because of the vital structures adjacent to the tumor. Intraoperative magnetic resonance imaging (MRI) might play an active role during brain tumor surgery because it compensates for brain shift or operation-induced hemorrhage, which are challenging issues for neurosurgeons.
  
  
  
  We reviewed 38 patients treated surgically under intraoperative MRI guidance between January 2008 and July 2015 at our center. Preoperative, intraoperative, and postoperative MRI scans were reviewed. Preoperative and postoperative motor power, morbidity and mortality, resection rate, surgical approach, pathologic results, and patient demographics were also reviewed.
  
  
  
  Mean patient age was 37 years ± 18; 12 patients were included in the low-grade group, and 26 patients were included in the high-grade group. Under intraoperative MRI guidance, the gross total resection rate was increased from 16 (42.1%) to 26 (68.4%), and the near-total or subtotal resection rate was increased from 5 (13.2%) to 9 (23.7%). Hematoma formation was discovered in 3 patients on intraoperative MRI scan; each patient underwent a hemostatic operation immediately.
  
  
  
  With improvements in neurosurgical techniques and equipment, surgical resection is considered feasible in patients with thalamic gliomas. Intraoperative MRI may be helpful in achieving the maximal resection rate with minimal surgical-related morbidity. However, because of severe disease progression, the overall prognosis is unfavorable.
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Xinghua
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Air Force General Hospital of the Chinese PLA, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Guochen
authors.initials: G
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Jiashu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Jinli
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China.
authors.forename: Bainan
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, PLA General Hospital, Beijing, China. Electronic address: junzhang301@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D056324:Diffusion Tensor Imaging; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D013788:Thalamus / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Diffusion tensor imaging; Functional MRI; Intraoperative MRI; Microsurgery; Thalamic glioma