Intraoperative resection control using arterial spin labeling - Proof of concept, reproducibility of data and initial results

TY - JOUR

T1 - Intraoperative resection control using arterial spin labeling - Proof of concept, reproducibility of data and initial results

AU - Lindner, Thomas

AU - Ahmeti, Hajrullah

AU - Lübbing, Isabel

AU - Helle, Michael

AU - Jansen, Olav

AU - Synowitz, Michael

AU - Ulmer, Stephan

PY - 2017

Y1 - 2017

N2 - OBJECTIVES: Intraoperative magnetic resonance imaging is a unique tool for visualizing structures during resection and/or for updating any kind of neuronavigation that might be hampered as a result of brain shift during surgery. Advanced MRI techniques such as perfusion-weighted imaging have already proven to be important in the initial diagnosis preoperatively, but can also help to differentiate between tumor and surgically induced changes intraoperatively. Commonly used methods to visualize brain perfusion include contrast agent administration and are therefore somewhat limited. One method that uses blood as an internal contrast medium is arterial spin labeling (ASL), which might represent an attractive alternative.MATERIALS AND METHODS: Ten healthy volunteers were examined using three different scanners and coils within 1 h (3T Achieva MRI using 32-channel head coil, 1.5T Achieva MRI using a 6-channel head coil, 1.5 Intera Scanner using 2 surface coils, Philips, Best, The Netherlands) and quantitative CBF values were calculated and compared between the different setups. Additionally, in eight patients with glioblastoma multiforme, ASL was used pre-, intra-, and postoperatively to define tumor tissue and the extent of resection in comparison to structural imaging.RESULTS: A high correlation (r = 0.91-0.96) was found between MRI scanners and coils used. ASL was as reliable as conventional MR imaging if complete resection was already achieved, but additionally provided valuable information regarding residual tumor tissue in one patient.CONCLUSIONS: Intraoperative arterial spin-labeling is a feasible, reproducible, and reliable tool to map CBF in brain tumors and seems to give beneficial information compared to conventional intraoperative MR imaging in partial resection.

AB - OBJECTIVES: Intraoperative magnetic resonance imaging is a unique tool for visualizing structures during resection and/or for updating any kind of neuronavigation that might be hampered as a result of brain shift during surgery. Advanced MRI techniques such as perfusion-weighted imaging have already proven to be important in the initial diagnosis preoperatively, but can also help to differentiate between tumor and surgically induced changes intraoperatively. Commonly used methods to visualize brain perfusion include contrast agent administration and are therefore somewhat limited. One method that uses blood as an internal contrast medium is arterial spin labeling (ASL), which might represent an attractive alternative.MATERIALS AND METHODS: Ten healthy volunteers were examined using three different scanners and coils within 1 h (3T Achieva MRI using 32-channel head coil, 1.5T Achieva MRI using a 6-channel head coil, 1.5 Intera Scanner using 2 surface coils, Philips, Best, The Netherlands) and quantitative CBF values were calculated and compared between the different setups. Additionally, in eight patients with glioblastoma multiforme, ASL was used pre-, intra-, and postoperatively to define tumor tissue and the extent of resection in comparison to structural imaging.RESULTS: A high correlation (r = 0.91-0.96) was found between MRI scanners and coils used. ASL was as reliable as conventional MR imaging if complete resection was already achieved, but additionally provided valuable information regarding residual tumor tissue in one patient.CONCLUSIONS: Intraoperative arterial spin-labeling is a feasible, reproducible, and reliable tool to map CBF in brain tumors and seems to give beneficial information compared to conventional intraoperative MR imaging in partial resection.

KW - Adult

KW - Aged

KW - Brain Neoplasms/diagnostic imaging

KW - Female

KW - Glioblastoma/diagnostic imaging

KW - Humans

KW - Magnetic Resonance Imaging/methods

KW - Male

KW - Middle Aged

KW - Monitoring, Intraoperative/methods

KW - Neuronavigation/methods

KW - Neurosurgical Procedures/methods

KW - Proof of Concept Study

KW - Reproducibility of Results

KW - Spin Labels

U2 - 10.1016/j.nicl.2017.04.021

DO - 10.1016/j.nicl.2017.04.021

M3 - SCORING: Journal article

C2 - 28507896

VL - 15

SP - 136

EP - 142

JO - NEUROIMAGE-CLIN

JF - NEUROIMAGE-CLIN

SN - 2213-1582

ER -