Utilization of intraoperative motor mapping in glioma surgery with high-field intraoperative magnetic resonance imaging

Background/Aims: The main goal of glioma surgery is to maximize tumor resection while minimizing neurologic injury. The use of high-field intraoperative magnetic resonance imaging (iMRI) and intraoperative cortical mapping (IOM) together enable the surgeon to increase the extent of tumor resection (EOR) and preserve the neurological function. However, there is insufficient evidence to validate the use of IOM with high-field iMRI. Methods: To study the safety and utility of IOM in a high-field (1.5 T) iMRI suite, we retrospectively studied 38 patients with glioma who underwent surgery with IOM in the iMRI suite. Results: We were able to use IOM in the iMRI suite without any adverse side effects or difficulty. Median EOR was 97%. A new or worsening motor deficit occurred in 14 (37%) patients immediately after the surgery, with 3 (8%) patients exhibiting persistent deficit at 6 months. Conclusion: Our findings suggest that IOM can be successfully used in a high-field MRI environment and can help minimize postoperative motor deficit with a higher EOR.