IGT logo

National Center for Image Guided Therapy

Clinical Experience with Intraoperative Imaging

We have retrospectively investigated the benefit of intraoperative MRI for the resection of brain tumors. No previous study has assessed the extent of glioma resection (EGR) in a patient population whose craniotomies were guided with iMRI and compared directly to the EGR in a separate control patient population whose craniotomies were guided by stereotactic navigational systems that did not have the availability to update the MR images intraoperatively. With relative freedom of selection and referral bias, we evaluated the EGR achieved among 132 patients that underwent craniotomy for tumor resection at the BWH. The EGR of 65 patients whose craniotomies was conducted with iMRI was compared to the EGR of 67 patients whose craniotomies were conducted with standard neuronavigational equipment in the conventional surgical suite.

iMRI showing a non-enhancing Oligoastrocytoma (WHO II) A. Well defined nonenhancing T2 hyperintense lesion in the left frontal lobe is seen. There is no surrounding edema. B. iMRI showing complete resection of the lesion and associated post-surgical changes.

Following our data gathering and analysis, our results showed that the implementation of iMRI allowed the neurosurgeons to significantly maximize the EGR and to increase the number of gross total resections (GTR) that were achieved. Our results also showed that the EGR and the GTR achieved among patients with low grade gliomas, and those with gliomas that did not have infiltration in to eloquent regions of the brain were also significantly increased when iMRI was implemented.

Volumetric Non-Rigid Registration for MRI-Guided Brain Tumor Surgery. Sample image of the open MRI dataset repository.

Within the NCIGT, several projects involve the analysis of anonymized MRI scans of patients who underwent intraoperative MR-guided therapy (MRT) in which imaging was used during surgery. To understand the utility of the technology and to make these datasets available for others outside the NCIGT, investigators are analyzing the scans and archiving them in a database. Researchers already have available as an open source database MR scans from prior MRT neurosurgical cases that can be used to validate non-rigid registration algorithms. Additional work is being done to create and populate brain tumor and brain biopsy databases that will characterize data by demographical and other characteristics including pathology.

MRT was pioneered at the Brigham and Women's Hospital, the center for the NCIGT. Beginning in 1993, researchers used a 0.5 T open configuration magnet co-developed by the BWH and GE Medical Systems to safely and effectively perform interventional procedures, including but not limited to open neurosurgery, prostate brachytherapy, and thermal ablation (cryotherapy). During the procedures, the scanner's design allowed access to the patient without the need to reposition him or her for imaging. In terms of case load for MRT, three neurosurgical procedures took place on average in the open magnet per week.

Completed work available to the IGT community that is related to archiving and retrospective analysis of MRI scans will continue to be found under Downloads along with other NCIGT resources.

Back to Research Projects.

Publications

Involved Investigators

Retrieved from "http://www.ncigt.org/pages/Research_Projects/MRT_Data_Mining"