LOW FIELD INTRAOPERATIVE MAGNETIC RESONANCE IMAGING GUIDED SURGERY OF SUPRATENTORIAL BRAIN TUMORS: FIRST SINGLE CENTER EXPERIENCE IN RUSSIA
In this paper we present the first Russia’s experience in supratentorial brain tumors surgery assisted by low field intraoperative magnetic resonance imaging (iMRI) using the PoleStar N20 movable magnet for neuronavigation and resection extent control. We performed surgeries on 7 patients with supratentorial brain tumors. The histological distribution of tumors was as follows: 4 (57,1%) glioblastomas WHO Gr IV, and one of each (14,3%): papillary craniopharyngioma, meningothelial meningioma Gr I and non-Hodgkin B-cell lymphoma. We used e-steady, contrast enhanced T1, T2 and FLAIR scans. The quality of acquired images was acceptable in each case. We had to perform more than two sequential MR-scans in cases with tumors expanding to the subcortical ganglia, located in the eloquent brain areas or close to the main blood vessels in order to maximize the precision of residual tumor resection while keeping it less traumatic. The use of low field iMRI has not significantly increase the time of surgery. iMRI technology served as immediate feedback allowing us to fully compensate the brain shift effect and therefore use it as the real-time guidance. In our opinion, the usage of intraoperative magnetic resonance imaging looks the most promising in the surgery of glial tumors, sellar area tumors as well as in basal meningiomas surgery. This method is proven to be effective and safe, serving to increase the extent of tumor resection and therefore provides for better surgical radicality. Refs 20. Figs 7.