Chapter 20 - Intraoperative MRI for High and Low Grade Gliomas

Abstract

Gliomas are central nervous system neoplasms that infiltrate the surrounding brain parenchyma, complicating their treatment. Tools that increase extent of resection (EOR) while preventing neurological deficit are vital for improving outcomes for patients diagnosed with gliomas. Intraoperative MRI (iMRI) can be used in the surgical resection of gliomas and has demonstrated great potential for maximizing extent of resection for both high and low grade gliomas in an attempt to improve patient outcomes. iMRI is a promising adjunct for the neurosurgical operating theater that is safe and effective in increasing EOR. However, it has limitations such as cost and need for specialized equipment. Although the majority of evidence is encouraging, it is primarily derived from retrospective studies, thus emphasizing the need for randomized trials more evident and necessary. Here, we review the current evidence supporting the use of iMRI for the resection of gliomas, the potential advantages, and limitations of this imaging technique in the operating room.