The Current Status of Intraoperative MRI and Its Future Perspective(<SPECIAL ISSUE>Operation Suite in 21st Century)

Abstract

In glioma surgeries, it is important to achieve maximal resection of the tumor and simultaneously avoid post-operative neurological deficits. Intraoperative magnetic resonance imaging (iMRI), introduced worldwide in 1995, is an effective tool that aids in achieving precision and safety in many operations, thus playing a major role in quality assurance of neurosurgery. We installed 2 iMRI operation rooms (ORs) in 2006 at our institutes, and have performed more than 500 operations. An analysis of 56 consecutive patients with newly diagnosed glioblastomas at our hospitals showed prolonged survival in those treated in iMRI ORs as compared to those treated in conventional ORs. Using a high-field iMRI, we also observed good correlation between intraoperative tractography of the pyramidal tract and motor evoked potential with direct white-matter stimulation. Here, we describe our experiences in using iMRI and a new imaging technique developed by us-Reshape & fuse. We have also discussed the current status of iMRI and its future perspective.