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Intraoperative MRI Neurosurgery: The Future of the Brain Surgery

20 Sep 2022

Magnetic resonance imaging (MRI) technology has been used in neurosurgical procedures for a long time. Using MRI, neurosurgeons can accurately perform both simple and complex neurosurgeries with high precision, efficiency, and speed. 

With the advancements in medical robotics and imaging technology, enhanced versions of MRI technology, such as intraoperative MRI neurosurgery, can provide neurosurgeons with a real-time brain view during surgery. It also allows them to detect abnormalities in the tissues and remove them precisely and safely.

What is MRI?

MRI is a type of medical imaging that produces precise scans of the organs and tissues inside the body using a magnetic field and radio waves produced by a computer. Large, magnetized tubes make up the majority of MRI equipment. The magnetic field causes the body's water molecules to momentarily realign when a patient is lying inside an MRI machine. To make cross-sectional MRI pictures, radio waves induce these aligned atoms to emit weak signals. 


The images captured by the MRI machines aid medical professionals in making a more accurate assessment of a patient.

Tesla, a unit of measurement for magnetic flux density, is used to rate the magnetic field's strength. Nikola Tesla, a physicist who discovered the rotating magnetic field in 1882, has been honored by having his name associated with this unit of measurement.

History of MR Imaging Technology

Raymond Damadian, an American physician, applied for the initial MRI patent in 1972. The medical professional and researcher discovered that MRI pictures could be beneficial when diagnosing a patient. Damadian was the first person to use an MRI machine to determine a patient's condition. 

The findings of Damadian were released in Science magazine in 1971. The March 19, 1971, article "Tumor Detection by Nuclear Resonance Imaging" showed that experimental rats' malignant and healthy tissue could be distinguished using nuclear magnetic resonance (NMR), from which the MR imaging technology has evolved.

Since its initial development, magnetic resonance imaging technology has advanced significantly. This technology has made it possible to come up with medical advancements that have improved the lives of patients suffering from life-threatening conditions. Moreover, advanced modifications to the way equipment such as intraoperative MRI (iMRI) is utilized make the neurosurgery procedure more efficient and easier for neurosurgeons.  

Role of Intraoperative MRI in Neurosurgery 

To reduce the danger of neurological injury during the procedure, the chance of incomplete resection and the eventual necessity for reoperation, the high-resolution pictures produced by the iMRI technology improve precision in intricate neurosurgical operations. The device provides real-time photographs while also accounting for the brain shift and movement of the surgical sites, thereby reducing the likelihood of error.


Patients typically need to have multiple brain surgeries to finish all the intricate steps at once. This is usually the case since an ordinary MRI is only used to assess surgical success after the procedure has been completed.

However, now that iMRI is available, the surgeon can view images of the surgical site while the patient is on the operating table. This gives the surgeons and the patients an advantage so that the procedure can be effectively finished in one setting. Therefore, one iMRI brain surgery is equivalent to numerous non-iMRI brain surgeries, significantly lowering the patient's risks and problems.

The combination of diagnostic MR imaging and iMRI also provides neurosurgeons with real-time contrast of the diseased area, allowing them to re-evaluate marginal tumor removal, account for brain displacement, and monitor the surgical procedure's progress to guarantee a safe and successful outcome. In addition to brain procedures, iMRI is also employed in ophthalmology, surgical oncology, radiation oncology, and other neurosurgeries.

Owing to the increasing prevalence of neurological disorders requiring surgical interventions and the growing demand for intraoperative imaging, the global MR imaging in neurosurgery market is expected to grow significantly.

However, globally, the exponential increase in COVID-19 cases has put a tremendous amount of strain on the healthcare system, particularly the suppliers of healthcare equipment. Governments everywhere were compelled to advise the medical community to put off elective surgeries and radiological diagnostic procedures to curb the spread of COVID-19. Actions that were undertaken to combat the pandemic had significant implications on the medical imaging and intraoperative imaging market

According to the BIS Research report, the market for MR imaging in neurosurgery was valued at $88.7 million in 2021 and is anticipated to reach $150.5 million by the end of 2031, registering a CAGR of 5.52% during the forecast period 2022-2031.

How does intraoperative MRI neurosurgery work? 

Newer models of iMRI suites have the MRI machine in the neighboring room, in contrast to earlier models that had the MRI inside the operating room but outside the magnetic field area. As a result, when not used for surgery, the MRI can be used as a diagnostic imaging tool for other patients. Additionally, it frees up additional space in the room and permits the use of standard surgical instruments that are incompatible with MRIs, minimizing the need for any operating room modifications.

The patient is operated on using a specialized neurosurgery table, the top of which may simply slide onto an MRI table while the patient is still in the operating position. This facilitates moving the patient to the imaging section, which is separate yet accessible through a single door.

Before the wound is stitched up, the MRI table docks onto the top of the unique neurosurgery table. The monitors and anesthetic equipment are then carefully transported with the patient to the imaging facility. The patient is then put on the top of the table and slid back onto the operating table following the completion of the imaging. With the new knowledge gleaned from the intraoperative iMRI scan, the surgery is proceeded with as necessary.

Conclusion

The human brain is responsible for controlling all fundamental processes, such as speaking and thinking, as well as movement. Therefore, any disease, illness, or injury to the brain or nervous system can interfere with everything, from simple to complex daily functions.

High-field systems and sophisticated iMRI can now be seamlessly linked with specialized surgical suites, neuronavigational systems, and digital image transfer and projection systems, owing to technological advancements in the field of neurosurgery. This has made it possible for patients to recover from brain illnesses and greatly enhanced both the quality of life and survival rates following brain surgery.

 
 
 
 

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