The predictive value of low-field strength magnetic resonance imaging for intraoperative residual tumor detection. Clinical article

J Neurosurg. 2009 Aug;111(2):252-7. doi: 10.3171/2008.9.JNS08729.

Abstract

Object: Neurosurgeons have been utilizing intraoperative MR (iMR) imaging to evaluate the extent of tumor resection since the 1990s. A low-field strength (0.12 T) MR imaging unit (PoleStar N20, Medtronic) is a practical and relatively inexpensive iMR imaging system that has found increased use in neurosurgery. The gold standard for post operative detection of residual tumor has been high-strength MR imaging performed within 48 hours of resection.The object of this study was to determine the predictive concordance of low-strength iMR imaging with standard high-strength MR imaging for detection of residual tumor.

Methods: The authors retrospectively evaluated the MR images from 74 intracranial tumor resections, comparing the intraoperative images obtained using a 0.12-T iMR imaging unit to the immediate postoperative images obtained using a standard 1.5-T MR imaging unit within 48 hours after surgery.

Results: The sensitivity of low-field MR imaging for detection of residual tumor was 0.74 (95% CI 0.58-0.86),and its specificity was 0.97 (95% CI 0.83-1). When only glial tumors (42 of the 74 lesions) were analyzed, the sensitivity was 0.82 (95% CI 0.59-0.94) and the specificity was 0.95 (95% CI 0.73-1).

Conclusions: These data could assist the neurosurgeon who has to decide intraoperatively whether the observed iMR images show residual tumor or not.

Publication types

  • Comparative Study

MeSH terms

  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / surgery
  • Humans
  • Intraoperative Period
  • Magnetic Resonance Imaging / methods*
  • Neoplasm, Residual / diagnosis*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity