Intraoperative MRI for resection of intracranial meningiomas.

Objective: To examine whether intraoperative MRI can enhance safety and extent of resection of complex intracranial meningiomas, given its positive role in the resection of malignant brain tumors and pituitary tumors.

Methods: Over a ten-year period, 70 operations were performed on 66 patients with intracranial meningiomas using the compact, mobile PoleStar N20 iMRI navigation system. A retrospective review was conducted examining patient demographics, surgical characteristics, and outcomes.

Results: 36 meningiomas were above the skull base and 30 were of the skull base. Four (5.7%) operations were done for recurrent meningiomas. 63 patients (95.5%) had WHO grade I and 3 patients (4.5%) had WHO grade III meningiomas. 9 (12.8%) patients required additional tumor resection based on iMRI findings, and in 4 patients (6%) iMRI imaging allowed for avoidance of additional dissection near critical neurovascular structures.

Conclusions: Up to 15.7% of patients had surgery positively affected by intraoperative imaging either improving the resection or avoiding unnecessary additional dissection which could potentially harm critical neurologic structures. As iMRI becomes more widely available it may be valuable to use in an appropriate subset of patients with intracranial meningiomas.