ioMRI guided tumour resection

Intra Op MRI (ioMRI) guided tumour resection

Surgery for Brain Tumours is always surrounded by an aura of fear owing to the risks involved. But over the years Neurosurgery has gone through several changes in terms of technique and technology, which has helped doctors perform many of the complex brain tumour surgeries confidently and safely.

Though MRI has been in use for quite some time for diagnostic purposes, its use during brain tumour surgery has added a new dimension to neurosurgery. Simply put, this technology aided by Neuronavigation gives neurosurgeons a “surgical GPS” – the ability to determine at any point during the operation the exact location within the brain to an accuracy of up to 1 mm. Aster RV hospital is one among the very few centres in INDIA to have this facility.

Intra op MRI is used to get real-time brain images during brain tumour surgery. To use MRI technology, the patient is moved from the operating room to an adjacent room, where MRI is performed. The images are transferred concurrently to the navigation system which guides the surgeon on the exact amount of residual tumour if any. This helps the surgeon to perform total resection of the brain tumour, which gives better survival and prevents redo surgeries.

Other present trends and advances in Brain Tumour surgeries:

  • Neuro navigation and image-guided resection: Neuronavigation helps neurosurgeons to precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI).

  • Fluorescence guided surgery: Fluorescein is a dye which when injected into the blood is taken up by few brain tumours especially high-grade gliomas, metastasis, meningiomas etc. and when these brain tumours are viewed under specific light conditions (yellow filter), using a microscope the tumour glows with the surrounding normal tissue, helping the surgeon to remove the brain tumour completely.

  • Intra op ultrasound: Ultrasound is a useful, cost-effective tool that can be used during surgery, to obtain real-time images of brain tumours during surgery.

  • Intra op neurophysiology monitoring and awake craniotomy In some instances, brain tumours may be very close to important (eloquent) areas of the brain neuromonitoring and awake craniotomy (patient will be fully awake during surgery and be asked to perform simple tasks and speak) are helpful to ensure eloquent areas are not damaged during tumour resection.

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