The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review

Background: Awake craniotomy for brain tumors remains an important tool in the arsenal of the treating neurosurgeon working in eloquent areas of the brain. Furthermore, with the implementation of intraoperative magnetic resonance imaging (I-MRI), one can afford the luxury of imaging to assess surgic...

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Main Authors: Tumul Chowdhury, Frederick A. Zeiler, Gyaninder P. Singh, Abseret Hailu, Hal Loewen, Bernhard Schaller, Ronald B. Cappellani, Michael West
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-10-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fonc.2018.00434/full
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spelling doaj-fc7c1950734e4ad5a306e8d2b96397262020-11-24T21:24:58ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2018-10-01810.3389/fonc.2018.00434412739The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic ReviewTumul Chowdhury0Frederick A. Zeiler1Frederick A. Zeiler2Frederick A. Zeiler3Gyaninder P. Singh4Abseret Hailu5Hal Loewen6Bernhard Schaller7Ronald B. Cappellani8Michael West9Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, CanadaSection of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, CanadaClincian Investigator Program, University of Manitoba, Winnipeg, MB, CanadaDivision of Anaesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, United KingdomDepartment of Neuroanaesthesiology & Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, IndiaMax Rady College of Medicine, University of Manitoba, Winnipeg, MB, CanadaCollege of Rehabilitation Sciences Librarian, Neil John Maclean Health Science Library, University of Manitoba, Winnipeg, MB, CanadaDepartment of Primary Care, University of Zurich, Zurich, SwitzerlandDepartment of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, CanadaSection of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, CanadaBackground: Awake craniotomy for brain tumors remains an important tool in the arsenal of the treating neurosurgeon working in eloquent areas of the brain. Furthermore, with the implementation of intraoperative magnetic resonance imaging (I-MRI), one can afford the luxury of imaging to assess surgical resection of the underlying gross imaging defined neuropathology and the surrounding eloquent areas. Ideally, the combination of I-MRI and awake craniotomy could provide the maximal lesion resection with the least morbidity and mortality. However, more resection with the aid of real time imaging and awake craniotomy techniques might give opposite outcome results. The goal of this systematic review.is to identify the available literature on combined I-MRI and awake craniotomy techniques, to better understand the potential morbidity and mortality associated.Methods: MEDLINE, EMBASE, and CENTRAL were searched from inception up to December 2016. A total of 10 articles met inclusion in to the review, with a total of 324 adult patients.Results: All studies showed transient neurological deficits between 2.9 to 76.4%. In regards to persistent morbidity, the mean was ~10% (ranges from zero to 35.3%) with a follow up period between 5 days and 6 months.Conclusion: The preliminary results of this review also suggest this combined technique may impose acceptable post-operative complication profiles and morbidity. However, this is based on low quality evidence, and is therefore questionable. Further, well-designed future trials with the long-term follow-up are needed to provide various aspects of feasibility and outcome data for this approach.https://www.frontiersin.org/article/10.3389/fonc.2018.00434/fullintraoperative magnetic resonance imaging (iMRI)awake craniotomiesoutcomecomplicationsbrain tumors
collection DOAJ
language English
format Article
sources DOAJ
author Tumul Chowdhury
Frederick A. Zeiler
Frederick A. Zeiler
Frederick A. Zeiler
Gyaninder P. Singh
Abseret Hailu
Hal Loewen
Bernhard Schaller
Ronald B. Cappellani
Michael West
spellingShingle Tumul Chowdhury
Frederick A. Zeiler
Frederick A. Zeiler
Frederick A. Zeiler
Gyaninder P. Singh
Abseret Hailu
Hal Loewen
Bernhard Schaller
Ronald B. Cappellani
Michael West
The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review
Frontiers in Oncology
intraoperative magnetic resonance imaging (iMRI)
awake craniotomies
outcome
complications
brain tumors
author_facet Tumul Chowdhury
Frederick A. Zeiler
Frederick A. Zeiler
Frederick A. Zeiler
Gyaninder P. Singh
Abseret Hailu
Hal Loewen
Bernhard Schaller
Ronald B. Cappellani
Michael West
author_sort Tumul Chowdhury
title The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review
title_short The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review
title_full The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review
title_fullStr The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review
title_full_unstemmed The Role of Intraoperative MRI in Awake Neurosurgical Procedures: A Systematic Review
title_sort role of intraoperative mri in awake neurosurgical procedures: a systematic review
publisher Frontiers Media S.A.
series Frontiers in Oncology
issn 2234-943X
publishDate 2018-10-01
description Background: Awake craniotomy for brain tumors remains an important tool in the arsenal of the treating neurosurgeon working in eloquent areas of the brain. Furthermore, with the implementation of intraoperative magnetic resonance imaging (I-MRI), one can afford the luxury of imaging to assess surgical resection of the underlying gross imaging defined neuropathology and the surrounding eloquent areas. Ideally, the combination of I-MRI and awake craniotomy could provide the maximal lesion resection with the least morbidity and mortality. However, more resection with the aid of real time imaging and awake craniotomy techniques might give opposite outcome results. The goal of this systematic review.is to identify the available literature on combined I-MRI and awake craniotomy techniques, to better understand the potential morbidity and mortality associated.Methods: MEDLINE, EMBASE, and CENTRAL were searched from inception up to December 2016. A total of 10 articles met inclusion in to the review, with a total of 324 adult patients.Results: All studies showed transient neurological deficits between 2.9 to 76.4%. In regards to persistent morbidity, the mean was ~10% (ranges from zero to 35.3%) with a follow up period between 5 days and 6 months.Conclusion: The preliminary results of this review also suggest this combined technique may impose acceptable post-operative complication profiles and morbidity. However, this is based on low quality evidence, and is therefore questionable. Further, well-designed future trials with the long-term follow-up are needed to provide various aspects of feasibility and outcome data for this approach.
topic intraoperative magnetic resonance imaging (iMRI)
awake craniotomies
outcome
complications
brain tumors
url https://www.frontiersin.org/article/10.3389/fonc.2018.00434/full
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