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Case Reports
. 2023 Jun 23:14:212.
doi: 10.25259/SNI_124_2023. eCollection 2023.

Intraoperative use of ultra-low-field, portable magnetic resonance imaging - first report

Ahmed Altaf  1 , Muhammad Waqas Saeed Baqai  2 , Faiza Urooj  1 , Muhammad Sami Alam  3 , Hafiza Fatima Aziz  1 , Fatima Mubarak  4 , Edmond Knopp  5 , Khan Siddiqui  5 , Syed Ather Enam  1
Affiliations
Case Reports

Intraoperative use of ultra-low-field, portable magnetic resonance imaging - first report

Ahmed Altaf et al. Surg Neurol Int. .

Abstract

Background: Intraoperative use of portable magnetic resonance imaging (pMRI) has become a valuable tool in a surgeon's arsenal since its inception. It allows intraoperative localization of tumor extent and identification of residual disease, hence maximizing tumor resection. Its utility has been widespread in high-income countries for the past 20 years, but in lower-middle-income countries (LMIC), it is still not widely available due to several reasons, including cost constraints. The use of intraoperative pMRI may be a cost-effective and efficient substitute for conventional MRI machines. The authors present a case where a pMRI device was used intraoperatively in an LMIC setting.

Case description: The authors performed a microscopic transsphenoidal resection of a sellar lesion with intraoperative imaging using the pMRI system on a 45-year-old man with a nonfunctioning pituitary macroadenoma. Without the need for an MRI suite or other MRI-compatible equipment, the scan was conducted within the confinements of a standard operating room. Low-field MRI showed some residual disease and postsurgical changes, comparable to postoperative high-field MRI.

Conclusion: To the best of our knowledge, our report provides the first documented successful intraoperative transsphenoidal resection of a pituitary adenoma using an ultra-low-field pMRI device. The device can potentially enhance neurosurgical capacity in resource-constrained settings and improve patient outcomes in developing country.

Keywords: Brain tumors; Intraoperative magnetic resonance imaging (Intraoperative MRI); Portable magnetic resonance imaging (Portable MRI); Ultra-low field magnetic resonance imaging (Ultra-low-field MRI).

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Preoperative scan, intraoperative scan, and delayed postoperative scans from magnetic resonance imaging scanner.
Figure 2:
Figure 2:
The portable magnetic resonance imaging (MRI) system in use in a standard operating room. Note that the operating room setup is not MRI compatible.
Figure 3:
Figure 3:
Representation of the Gauss field generated by the low-field portable magnetic resonance imaging scanner.
Figure 4:
Figure 4:
Comparison of the magnetic fringe field generated by the ultra-low-field 0.064 T portable magnetic resonance imaging scanner and a standard 1.5 T imaging scanner.
See this image and copyright information in PMC

References

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