TY - JOUR
T1 - Advanced intraoperative MRI in pediatric brain tumor surgery
AU - Jellema, Pien E. J.
AU - Wijnen, Jannie P.
AU - de Luca, Alberto
AU - Mutsaerts, Henk J. M. M.
AU - Obdeijn, Iris V.
AU - van Baarsen, Kirsten M.
AU - Lequin, Maarten H.
AU - Hoving, Eelco W.
N1 - Funding Information: We gratefully acknowledge funding of the European Union: Eurostars E! 12449 IMAGINE! and the Dutch Research Council: NWO-VIDI 18361_JW. Publisher Copyright: Copyright © 2023 Jellema, Wijnen, De Luca, Mutsaerts, Obdeijn, van Baarsen, Lequin and Hoving.
PY - 2023
Y1 - 2023
N2 - Introduction: In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides “real-time” imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging. Methods: Our systematic literature search identified relevant articles on PubMed using keywords associated with pediatrics, ioMRI, and brain tumors. The literature search was extended using the snowball technique to gather more information on advanced MRI techniques, their technical background, their use in adult ioMRI, and their use in routine pediatric brain tumor care. Results: The available literature was sparse and demonstrated that advanced sequences were used to reconstruct fibers to prevent damage to important structures, provide information on relative cerebral blood flow or abnormal metabolites, or to indicate the onset of hemorrhage or ischemic infarcts. The explorative literature search revealed developments within each advanced MRI field, such as multi-shell diffusion MRI, arterial spin labeling, and amide-proton transfer-weighted imaging, that have been studied in adult ioMRI but have not yet been applied in pediatrics. These techniques could have the potential to provide more accurate fiber tractography, information on intraoperative cerebral perfusion, and to match gadolinium-based T1w images without using a contrast agent. Conclusion: The potential added value of advanced MRI in the intraoperative setting for pediatric brain tumors is to prevent damage to important structures, to provide additional physiological or metabolic information, or to indicate the onset of postoperative changes. Current developments within various advanced ioMRI sequences are promising with regard to providing in-depth tissue information.
AB - Introduction: In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides “real-time” imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging. Methods: Our systematic literature search identified relevant articles on PubMed using keywords associated with pediatrics, ioMRI, and brain tumors. The literature search was extended using the snowball technique to gather more information on advanced MRI techniques, their technical background, their use in adult ioMRI, and their use in routine pediatric brain tumor care. Results: The available literature was sparse and demonstrated that advanced sequences were used to reconstruct fibers to prevent damage to important structures, provide information on relative cerebral blood flow or abnormal metabolites, or to indicate the onset of hemorrhage or ischemic infarcts. The explorative literature search revealed developments within each advanced MRI field, such as multi-shell diffusion MRI, arterial spin labeling, and amide-proton transfer-weighted imaging, that have been studied in adult ioMRI but have not yet been applied in pediatrics. These techniques could have the potential to provide more accurate fiber tractography, information on intraoperative cerebral perfusion, and to match gadolinium-based T1w images without using a contrast agent. Conclusion: The potential added value of advanced MRI in the intraoperative setting for pediatric brain tumors is to prevent damage to important structures, to provide additional physiological or metabolic information, or to indicate the onset of postoperative changes. Current developments within various advanced ioMRI sequences are promising with regard to providing in-depth tissue information.
KW - advanced MRI
KW - intraoperative MRI
KW - pediatric brain tumor patients
KW - postoperative changes
KW - surgical anatomy
UR - http://www.scopus.com/inward/record.url?scp=85159791247&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fphys.2023.1098959
DO - https://doi.org/10.3389/fphys.2023.1098959
M3 - Review article
C2 - 37123260
SN - 1664-042X
VL - 14
JO - Frontiers in physiology
JF - Frontiers in physiology
M1 - 1098959
ER -