Use of intraoperative MRI for resection of intracranial tumors: A nationwide analysis of short-term outcomes. (May 2022)

• Record Type: Journal Article
• Authors: Fuentes, Angelica M.; Ansari, Darius; Burch, Taylor G.; Mehta, Ankit I.
• Is Part Of: Journal of clinical neuroscience. Volume 99(2022)
• Page Start: 152
• Page End: 157
• Publication Date: 2022-05
• Subjects: Craniotomy -- Intracranial tumor -- Length of stay -- MRI -- Tumor resection; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2022.03.005
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Intraoperative MRI (iMRI) has demonstrated clinical benefit for brain tumor resection. Large, nationwide analyses of outcomes following its use are lacking. We used a national database to study tumor resection with or without iMRI. Use of intraoperative MRI resulted in longer operative length. No significant difference in inpatient adverse events including infection was noted. Abstract: Objective: Recent evidence supports the use of intraoperative MRI (iMRI) during resection of intracranial tumors due to its demonstrated efficacy and clinical benefit. Though many single-center investigations have been conducted, larger nationwide outcomes have yet to be characterized. Methods: We used the American College of Surgeons National Surgical Quality Improvement Program database to examine baseline characteristics and 30-day postoperative outcomes among patients undergoing craniotomy for tumor resection with and without iMRI. Comparisons between outcomes were accomplished after propensity matching using chi-square tests for categorical variables and Welch two-sample t-tests for continuous variables. Results: A total of 38, 003 patients met inclusion criteria. Of this population, 54 (0.1%) received iMRI, while 37, 949 (99.9%) did not receive iMRI. After propensity score matching, the resulting groups consisted of an iMRI group (n = 54) and a matched non-iMRI group (n = 54). Procedures involving iMRI were associated with significantly increased operation length compared to those without (p < 0.01). Length of hospital stay was higher in patients without iMRI, with this difference trending towards significance (p = 0.05) in the unmatched comparison. Patients undergoing craniotomy without iMRI had a higher rate of readmission (p = 0.04). There was no significant difference in occurrence of other adverse events between the two patient groups. Conclusion: Despite increasing operative length, iMRI is not associated with higher infection rate and may have a clinical benefit associated with reducing readmissions and a trend towards reducing inpatient length of stay. Additional nationwide analyses including more iMRI patients would provide further insight into the strength of these findings.