ISEKI Hiroshi    Department   Research Institutes and Facilities, Research Institutes and Facilities    Position
Article types	Review article
Language	English
Peer review	Non peer reviewed
Title	Intelligent operating theater using intraoperative open-MRI
Journal	Formal name：Magn Reson Med Sci ISSN code：13473182
Volume, Issue, Page	4(3),pp.129-136
Author and coauthor	ISEKI Hiroshi†, MURAGAKI Yoshihiro, NAKAMURA Ryoichi , OZAWA Norihiko, TANIGUCHI Hiroki , TAKAKURA Kintomo
Authorship	Lead author
Publication date	2005/11
Summary	Malignant brain tumors vary among patients and are characterized by their irregular shapes and infiltration. Localization of functional areas in the brain also differs among patients, and excess removal of tumor near eloquent areas may increase the risk of damage of function, such as motor paresis and speech disturbance. Recent progress in magnetic resonance (MR) imaging technology has enabled acquisition of intraoperative images and totally changed the neurosurgery of malignant brain tumors. Before, surgeons could merely speculate about the results of surgical manipulation and have no certainty about procedure outcomes until postoperative examination. Because intraoperative MR images allow visualization of the size of residual tumor(s) and the positional relationship between thetumor(s) and eloquent areas, surgeons are now able to achieve safe and reliable surgery. As an example, positional error on preoperative MR images caused by shifting of the brain (brain shift), a long-standing annoyance for surgeons, has been resolved using intraoperative MR images for surgical navigation, allowing precise resection. Two types of open-MR imaging scanner, a 0.2- or 0.3-tesla hamburger-type scanner with a horizontal gap and a 0.12- or 0.5-tesla double doughnut-type scanner with a vertical gap, are now available in the operating theater, and 1.5-tesla bore-type scanners are available. A 3.0-tesla bore-type scanner is planned. Intraoperative MR imaging includes diffusion-tensor and diffusion-weighted imaging, which allows visualization of nerve fibers in the white matter, especially the pyramidal tract. Such images are valuable aids in the precise resection of residual lesions of malignant brain tumors near eloquent areas without injuring motor function.
DOI	10.2463/mrms.4.129.
Document No.	2006310107
PMID	16462133