Intraoperative MRI for newly diagnosed supratentorial glioblastoma: a multicenter-registry comparative study to conventional surgery.

Objective: Intraoperative MRI (iMRI) is used in the surgical treatment of glioblastoma, with uncertain effects on outcomes. The authors evaluated the impact of iMRI on extent of resection (EOR) and overall survival (OS) while controlling for other known and suspected predictors.

Methods: A multicenter retrospective cohort of 640 adult patients with newly diagnosed supratentorial glioblastoma who underwent resection was evaluated.

Using Histopathology to Assess the Reliability of Intraoperative Magnetic Resonance Imaging in Guiding Additional Brain Tumor Resection: A Multicenter Study.

Background: Intraoperative magnetic resonance imaging (iMRI) is a powerful tool for guiding brain tumor resections, provided that it accurately discerns residual tumor.

Objective: To use histopathology to assess how reliably iMRI may discern additional tumor for a variety of tumor types, independent of the indications for iMRI.

Methods: A multicenter database was used to calculate the odds of additional resection during the same surgical session for grade I to IV gliomas and pituitary adenomas.

Impact of 3-Dimensional Versus 2-Dimensional Image Distortion Correction on Stereotactic Neurosurgical Navigation Image Fusion Reliability for Images Acquired With Intraoperative Magnetic Resonance Imaging.

Background: Fusion of preoperative and intraoperative magnetic resonance imaging (iMRI) studies during stereotactic navigation may be very useful for procedures such as tumor resections but can be subject to error because of image distortion.

Objective: To assess the impact of 3-dimensional (3D) vs 2-dimensional (2D) image distortion correction on the accuracy of auto-merge image fusion for stereotactic neurosurgical images acquired with iMRI using a head phantom in different surgical positions.

Methods: T1-weighted intraoperative images of the head phantom were obtained using 1.

Image Guidance in Cranial Neurosurgery: How a Six-Ton Magnet and Fluorescent Colors Make Brain Tumor Surgery Better.

Maximal safe resection can improve patient outcomes for a variety of brain tumor types including low- and high-grade gliomas, pituitary adenomas, and other pathologies. Numerous intraoperative adjuncts exist to guide surgeons with maximizing extent of resection. Three distinct strategies exist including: 1) surgical navigation; 2) intraoperative imaging; and 3) tumor fluorescence.

Initial Experience Using Intraoperative Magnetic Resonance Imaging During a Trans-Sulcal Tubular Retractor Approach for the Resection of Deep-Seated Brain Tumors: A Case Series.

Background: Treatment of deep-seated subcortical intrinsic brain tumors remains challenging and may be improved with trans-sulcal tubular brain retraction techniques coupled with intraoperative magnetic resonance imaging (iMRI).

Objective: To conduct a preliminary assessment of feasibility and efficacy of iMRI in tubular retractor-guided resections of intrinsic brain tumors.

Methods: Assessment of this technique and impact upon outcomes were assessed in a preliminary series of brain tumor patients from 2 centers.

Predicting Unplanned Transfers to the Intensive Care Unit: A Machine Learning Approach Leveraging Diverse Clinical Elements.

Background: Early warning scores aid in the detection of pediatric clinical deteriorations but include limited data inputs, rarely include data trends over time, and have limited validation.

Objective: Machine learning methods that make use of large numbers of predictor variables are now commonplace. This work examines how different types of predictor variables derived from the electronic health record affect the performance of predicting unplanned transfers to the intensive care unit (ICU) at three large children's hospitals.

Endovascular management of internal carotid artery injuries secondary to endonasal surgery: case series and review of the literature.

OBJECTIVE Internal carotid artery (ICA) injury is a rare but severe complication of endonasal surgery. The authors describe their endovascular experience managing ICA injuries after transsphenoidal surgery; they review and summarize the current literature regarding endovascular techniques; and they propose a treatment algorithm based on the available evidence. METHODS A retrospective review of 576 transsphenoidal pituitary adenoma resections was performed.

Management of atypical cranial meningiomas, part 1: predictors of recurrence and the role of adjuvant radiation after gross total resection.

Background: Indications for external beam radiation therapy (EBRT) for atypical meningiomas (AMs) remain unclear.

Objective: To analyze features associated with recurrence in AM patients after gross total resection (GTR) and to assess the relative benefit of EBRT in a retrospective cohort study.

Methods: One hundred fifty-one primary AMs after GTR (88 female patients; median follow-up, 45.

Pulmonary toxicity in a rabbit model of stereotactic lung radiation therapy: efficacy of a radioprotector.

This study aimed to assess the efficacy of the radioprotector amifostine in limiting radiation toxicity in a rabbit model of lung stereotactic body radiation therapy (SBRT) by correlating contrast-enhanced magnetic resonance angiography (ce-MRA), computed tomography (CT), and helium-3 (He-3) magnetic resonance imaging (MRI) with histopathology. Multiple MRI techniques were tested to obtain complementing physiologic information. Thirteen rabbits received SBRT to the right lower lobe of the lung.

Combined high-field intraoperative magnetic resonance imaging and endoscopy increase extent of resection and progression-free survival for pituitary adenomas.

Purpose: The clinical benefit of combined intraoperative magnetic resonance imaging (iMRI) and endoscopy for transsphenoidal pituitary adenoma resection has not been completely characterized. This study assessed the impact of microscopy, endoscopy, and/or iMRI on progression-free survival, extent of resection status (gross-, near-, and sub-total resection), and operative complications.

Methods: Retrospective analyses were performed on 446 transsphenoidal pituitary adenoma surgeries at a single institution between 1998 and 2012.

Characterization and detection of physiologic lung changes before and after placement of bronchial valves using hyperpolarized helium-3 MR imaging: preliminary study.

Rationale And Objectives: The aim of this study was to determine the efficacy of hyperpolarized (3)He (HHe) ventilation and apparent diffusion coefficient (ADC) HHe magnetic resonance imaging (MRI) in detecting changes in lung function and microstructure in emphysematous lung after bronchial valve (BV) placement.

Materials And Methods: One patient diagnosed with emphysema had nine BVs placed in upper lobe bronchi. Imaging was performed before and 6 months after BV placement.