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Utility of the Polestar N30 low-field MRI system for resecting non-enhancing intra-axial brain lesions
Affiliations- Sackler Faculty of Meducine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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Abstract
Background. To determine the utility of an intraoperative magnetic resonance imaging (iMRI) system, the Polestar N30, for enhancing the resection control of non-enhancing intra-axial brain lesions.
Materials and methods. Seventy-three patients (60 males [83.3%], mean age 37 years) with intra-axial brain lesions underwent resection at Sheba Medical Centre using the Polestar between February 2012 and the end of August 2018. Demographic and imaging data were retrospectively analysed. Thirty-five patients had a non-enhancing lesion (48%).
Results. Complete resection was planned for 60/73 cases after preoperative imaging. Complete resection was achieved in 59/60 (98.3%) cases. After iMRI, additional resection was performed in 24/73 (32.8%) cases, and complete resection was performed in 17/60 (28.8%) cases in which a complete resection was intended. In 6/13 (46%) patients for whom incomplete resection was intended, further resection was performed. The extent of resection was extended mainly for non-enhancing lesions: 16/35 (46%) as opposed to only 8/38 (21%) for enhancing lesions. Further resection was not significantly associated with sex, age, intended resection, recurrence, or affected side. Univariate analysis revealed non-eloquent area, intended complete resection, and enhancing lesions to be predictive factors for complete resection, and non-enhancing lesions and scan time to be predictive factors for an extended resection. Non-enhancement was the only independent factor for extended resection.
Conclusions. The Polestar N30 is useful for evaluating residual non-enhancing intra-axial brain lesions and achieving maximal resection.
Abstract
Background. To determine the utility of an intraoperative magnetic resonance imaging (iMRI) system, the Polestar N30, for enhancing the resection control of non-enhancing intra-axial brain lesions.
Materials and methods. Seventy-three patients (60 males [83.3%], mean age 37 years) with intra-axial brain lesions underwent resection at Sheba Medical Centre using the Polestar between February 2012 and the end of August 2018. Demographic and imaging data were retrospectively analysed. Thirty-five patients had a non-enhancing lesion (48%).
Results. Complete resection was planned for 60/73 cases after preoperative imaging. Complete resection was achieved in 59/60 (98.3%) cases. After iMRI, additional resection was performed in 24/73 (32.8%) cases, and complete resection was performed in 17/60 (28.8%) cases in which a complete resection was intended. In 6/13 (46%) patients for whom incomplete resection was intended, further resection was performed. The extent of resection was extended mainly for non-enhancing lesions: 16/35 (46%) as opposed to only 8/38 (21%) for enhancing lesions. Further resection was not significantly associated with sex, age, intended resection, recurrence, or affected side. Univariate analysis revealed non-eloquent area, intended complete resection, and enhancing lesions to be predictive factors for complete resection, and non-enhancing lesions and scan time to be predictive factors for an extended resection. Non-enhancement was the only independent factor for extended resection.
Conclusions. The Polestar N30 is useful for evaluating residual non-enhancing intra-axial brain lesions and achieving maximal resection.
Keywords
glioma, image guided surgery, MRI, surgical management
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About this articleTitle
Utility of the Polestar N30 low-field MRI system for resecting non-enhancing intra-axial brain lesions
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
202-211
Published online
2021-02-09
Page views
876
Article views/downloads
465
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2021;55(2):202-211.
Keywords
glioma
image guided surgery
MRI
surgical management
Authors
Lior Ungar
Zion Zibly
Anton Wohl
Ran Harel
Moshe Hadani
Moshe Attia
Roberto Spiegelmann
Zeev Feldman
Jacob Zaubermann
Nachshon Knoller
Zvi R. Cohen
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