ArticleNeurosurgical review2021
Technical limitations and pitfalls of diffusion-weighted imaging in intraoperative high-field MRI.
Article in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Passive intraoperative motor fMRI under general anesthesia during open-craniotomy glioma surgery: a prospective technical feasibility study.Brain & spine · 2026Article
- Review
- Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery.Scientific reports · 2025Article
- Survival implications of postoperative restricted diffusion in high-grade glioma and limitations of intraoperative MRI detection.Journal of neuro-oncology · 2024Article
- Prevalence and characteristics of vascular cognitive impairment in a European cohort of adult patients with Moyamoya angiopathy.Journal of neurology · 2024Article
- PyHySCO: GPU-enabled susceptibility artifact distortion correction in seconds.Frontiers in neuroscience · 2024Article
- Quantitative Validation of the Correlation Between Optimized Pyramidal Tract Delineation After Brain Shift Compensation and Direct Electrical Subcortical Stimulation During Brain Tumor Surgery.Journal of digital imaging · 2023Article
- Advances in the intraoperative delineation of malignant glioma margin.Frontiers in oncology · 2023Review
- Intraoperative MR Imaging during Glioma Resection.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2022Review
- Failure of diffusion-weighted imaging in intraoperative 3 Tesla MRI to identify hyperacute strokes during glioma surgery.Scientific reports · 2021Article
- Impact of additional resection on new ischemic lesions and their clinical relevance after intraoperative 3 Tesla MRI in neuro-oncological surgery.Neurosurgical review · 2021Article
- Comparison of intraoperative and post-operative 3-T MRI performed at 24-72 h following brain tumour resection in children.Neuroradiology · 2021Article
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5 authors.
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Abstract
objectiveImage quality in high-field intraoperative MRI (iMRI) is often influenced negatively by susceptibility artifacts. While routine sequences are rather robust, advanced imaging such as diffusion-weighted imaging (DWI) is very sensitive to susceptibility resulting in insufficient imaging data. This study aims to analyze intraoperatively acquired DWI to identify the main factors for susceptibility, to compare results with postoperative images and to identify technical aspects for improvement of intraoperative DWI.
methods100 patients with intraaxial lesions operated in a high-field iMRI were analyzed retrospectively for the quality of intraoperative DWI in comparison to the postoperative scan. General quality of the MR scan, individual diffusion restrictions, artifacts, and their causes were analyzed.
resultsInclusion criteria were met in 78 patients, 124 diffusion restrictions were included in the comparative analysis. PPV and NPV for the detection of DWI changes intraoperatively were 0.94 and 0.56, respectively (SEN 0.94; SPE 0.56). Image quality was rated significantly (p < 0.0001) worse intraoperatively compared to the postoperative MRI. The main reasons for reduced image quality intraoperatively were air (64%) and artificial material (e.g., compress) (38%) in the resection cavity, as well as positioning of patient's head outside the MR's isocenter 37%. Analysis of surgical approaches showed that frontal craniotomies have the highest risk of limited image quality (40%), whereat better results (15% limited image quality) were seen for all other approaches (p = 0.059).
conclusionIntraoperative DWI showed reliable results in this analysis. However, image-quality was limited severely in many cases leading to uncertainty in the interpretation. Susceptibility-causing factors might be prevented in many cases, if the surgical team is aware of them. The most important factors are good filling of the resection cavity with irrigation fluid, not placing artificial materials in the resection cavity and adequate positioning of patient's head according to the MR isocenter.
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