Speakers

High field intraoperative MRI in neuro-oncology: NTUH experiences
1109 16:15-16:25
AASNS & WANS Joint Seminar/305
Intraoperative magnetic resonance imaging (ioMRI) during surgical procedure was first implicated in mid-1990. Its use, especially high field (1.5-T or 3-T), is becoming increasingly widespread in neurosurgical practice worldwide. Most of the data support its use in a variety of neurosurgical procedures, especially tumor and functional surgeries. National Taiwan University build the only ioMRI, robotic C-arm combined surgical suite (a two-room setting design) in Taiwan, started neurosurgical procedures since April, 2022. With the new head-clamp, carbon top with transfer trolley, and moving cart, patients were sent for MRI examination smoothly and safely. The designed workflow allowed 30 minutes preparation in advance and standard examination time. Navigation, intraoperative neuromonitoring, 2nd look surgery can all be safely performed with the patient in either supine, 3/4 prone, or prone position. There were no wound infection, anesthesia or procedure related complications in our preliminary cases. Glioma and pituitary tumor are the most common diseases treated in ioMRI suite reported. Since extent of resection (EOR) has now been considered paramount relevant to overall survival, progression free survival and functional preservation in both low grade and high grade gliomas. By re-registration or markers placed intraoperatively, 2nd look surgery is common and safe. EOR for both glioma and pituitary tumor increased by incorporation of ioMRI without significant drawbacks. In limited experiences, we also considered its value in brain stem or spinal cord tumor surgery.