Intraoperative MRI for transsphenoidal resection of pituitary tumors:
Community hospital experience
Abstract
BACKGROUND: Intraoperative MRI (iMRI) is a definitive technology in
neurosurgery that has been used effectively to maximize outcomes for
transsphenoidal resection of pituitary tumors. IMRI has been seen to
provide optimal visualization of surrounding vital neurovascular
structures and has helped surgeons achieve gross total resection. The
use of iMRI in the community hospital setting has not been documented in
the current literature as of yet. OBJECTIVE: This study aims to provide
insight into the experiences of iMRI use in a community hospital setting
and add to the growing literature of iMRi use for transsphenoidal
resection of pituitary tumors. METHODS: A retrospective review of 56
patients who underwent iMRI guided transsphenoidal pituitary tumor
resection at Northwestern Medicine Central Dupage Hospital (from
November 2011 to April 2018) was performed. RESULTS: Gross total
resection was found in 67% (n=37) of patients who underwent iMRI. 33%
(n=19) did not achieve gross total resection of their pituitary mass.
IMRi was used exactly one time during the case in 96% (n=54) of
patients. IMRi was used more than once during the case in 4% (n=2) of
patients. Post operative tumor residual was found in 32% (n=6) of
patients who had available post-operative MRI studies (n=19).
CONCLUSIONS: Our study shows that iMRI can be useful in a community
hospital setting to achieve gross total resection during transsphenoidal
pituitary tumor resection. It also demonstrates the ability and need to
utilize iMRI only one time during a case which lends itself to operative
efficiency.