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Resection of anaplastic astrocytoma with MR-OR

Case Study
Kremer, Paul, M.D., Ph.D. Asklepios Clinic Hamburg, Neurosurgical Department, • Germany

Patient history

31-year-old female with an incompletely resected tumor in another neurosurgical unit some months before. She underwent surgery with intra-operative MR at Asklepios Clinic, Hamburg, Germany.

MR examination

Pre-operative and intra-operative MR was performed on Achieva 1.5T. This system is installed in a dual-room MR-OR setup, so that can be used both as an independent MR scanner and for intra-operative MR imaging.

MR images

Click an image for enlarged view
 Pre-op coronal T2W Pre-op axial T2W
Pre-op coronal T2W
Pre-op axial T2W

Pre-operative T2-weighted MRI demonstrates a huge residual tumor mass right temporal.
The tumor was resected under neuro-navigational guidance.

 Intra-op T1W Intra-op FLAIR
Intra-op T1W
Intra-op FLAIR

Intra-operative T1-weighted and FLAIR images show a complete tumor resection, however, some fluid contents within the resection area make interpretation of the intra-operative images more difficult.

Diagnosis and result

Intra-operative MRI helped to determine completeness of resection during neuro surgery.The patient could be discharged from the hospital 10 days after surgery with the recommendation of following chemotherapy.

Impact of intra-operative MR

At Asklepios intra-operative MRI is used to check the resection because it is difficult to determine tumor margins during resection. In Heidelberg several studies were performed on the benefits for the patient, and these indeed showed a large benefit for the patient

Related reading

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Feb 19, 2013

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Case Study
Achieva 1.5T
Brain, Interventional, Intra-operative MR, MR-OR, Neuro, Oncology

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