Intraoperative MRI in brain surgery

Neuronavigation is a frequently used method in the planning of intracranial neurosurgical procedures. During surgery however, due to anatomical changes such as loss of cerebrospinal fluid, tumour resection and oedema, preoperative data become inaccurate. Updated data acquisition during the procedure using intraoperative MRI (iMRI) overcomes this problem, as it enables maximum tumour resection or accurate tumour biopsy, whilst minimizing the risk of damaging healthy brain tissue. The choice between low field and high field strength systems depends on the desired image quality and integration into the regular workflow. In spite of its high costs, iMRI surgery seems to be cost-effective, due to reduced length of hospital stay, reduced repeat resection, and reduced hospital charges. In the future, intraoperative imaging combined with virtual planning stations, is expected to play an important role in implementing robotization into neurosurgery.