ArticleBrain & spine2026
The utility of intraoperative magnetic resonance imaging in recurrent glioblastoma surgery: A volumetric analysis.
Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Intraoperative magnetic resonance imaging (iMRI) for the resection of newly diagnosed glioblastoma has shown efficacy comparable to fluorescence guidance; however, its role in recurrent glioblastoma (recGB) remains unclear. This study evaluated the efficacy and safety of iMRI-guided recGB surgery. Methods: Consecutive patients with recGB undergoing iMRI-guided re-resection between 2015 and 2023 were retrospectively analyzed. Contrast-enhancing (CE) tumor volumes from preoperative (3T), intraoperative (1.5T), and early postoperative (epMRI, 3T) scans were assessed per RANO Resect criteria. The impact of iMRI on intraoperative decision-making for additional resection (AR), functional outcomes, and survival was evaluated. Results: A total of 150 patients were included. Complete CE tumor resection was intended in 85% (n = 127). iMRI prompted AR in 77% (n = 115), increasing RANO class 1-2 resections from 58% on iMRI to 85% on epMRI. A "RANO-switch" (conversion from class 3 on iMRI to class 1-2 on epMRI) occurred in 27% (n = 41). Preoperative CE tumor volume was the only independent predictor of AR (p = 0.001), with 6.9 ml identified as the cut-off above which AR was significantly more likely to achieve a "RANO-switch." Neurological deterioration was not associated with AR (transient: 15% vs 16%; permanent: 2% vs 3%). Median survival after re-resection was 11 months. Gross total resection (residual tumor volume ≤0.175 ml), but not RANO class, independently predicted improved survival (HR 0.50, p = 0.006). Conclusion: In recGB, where a real-time intraoperative information about RTV could be relevant, iMRI significantly improved the extent of resection without increasing the risk of neurological deficits. Larger preoperative CE tumor volumes were associated with a greater resection benefit from iMRI, supporting its efficacy and safety in recGB surgery.
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