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Intraoperative MRI for transsphenoidal resection of pituitary tumors: Community hospital experience
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  • Alvin Onyewuenyi,
  • Andrew Fishman,
  • Andrew Chenelle,
  • Taras Masnyk,
  • Sheri Dewan
Alvin Onyewuenyi
Rosalind Franklin University of Medicine and Science Chicago Medical School

Corresponding Author:[email protected]

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Andrew Fishman
Northwestern Medicine Regional Medical Group
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Andrew Chenelle
Northwestern Medicine Regional Medical Group
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Taras Masnyk
Northwestern Medicine Regional Medical Group
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Sheri Dewan
Northwestern Medicine Regional Medical Group
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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.