Magnetic Resonance Elastography as Tool for Surgical Planning
Researchers at Mayo Clinic have used magnetic resonance elastography (MRE) to assess pituitary tumour stiffness by measuring waves transmitted through the skull into pituitary macroadenomas. MRE, often called “palpating by imaging”, non-invasively identified tumours removable by simple versus complex surgeries, according to a study published in the journal Pituitary.
MRE captures snapshots of shear waves that move through the tissue and create elastograms, or images that show tissue stiffness. Ninety percent of pituitary macroadenomas (PMAs) are soft — nearly the consistency of toothpaste. Using MRE, hard PMAs can be identified and the more extensive craniotomy can be planned before starting the surgery, which makes the more invasive procedure less taxing for both the surgeon and patient.
In the new study, the Mayo team performed pre-surgical MRE examination of the PMAs of 10 patients. The MRE measurements were compared to tumour classifications made by inspection of the tumour during surgery. The surgeons categorised six tumours as soft and four tumours as medium. No tumours were deemed to be hard. The comparison of the MRE results and reports of stiffness by the surgeons when the tumour was removed and inspected were in close agreement, which was confirmed by statistical analysis.
Although brain MRE is not yet widely available, the technique is now routinely used by surgeons at the Mayo Clinic to plan the best procedure for the removal of PMAs as well as several other types of brain tumour. An important aspect of some of the other brain tumour types, which the Mayo surgeons are finding extremely useful, is the ability of MRE to identify tumour adhesion to the brain, says John Huston III, MD, professor of radiology at the Mayo Clinic in Rochester, MN, and senior author of the study.
Adhesion refers to whether the brain tumour and healthy brain tissue are connected by an extensive network of blood vessels and connective tissue. This is in comparison with a tumour that is in the brain but is isolated from healthy tissue. When MRE is used to analyse this aspect of the tumour, it clearly identifies those that are non-adhered, showing a border around the tumour through which there are no vascular connections. In contrast, MRE of adhered tumours show no border between the tumour and healthy brain, indicating extensive vascular and soft tissue connections between brain and tumour.
According to Prof. Huston, his team is continuing to apply MRE to diagnosis of other brain disorders. In addition to characterising focal brain disorders such as tumours, the team is testing the potential for MRE to provide diagnostic information about diffuse brain disease. MRE brain stiffness patterns are also used to identify different types of neural disorders including dementia.
Source & Image: National Institute of Biomedical Imaging and Bioengineering
Published on : Tue, 31 Jan 2017
UltraDrape is an innovative dressing designed for use during Ultrasound-Guided Peripheral Intravenous (UGPIV) that provides dual-action barrier and securement in one.
Redefining the Vision of Cardiovascular The LISENDO 880 is Hitachi’s premium 2D/4D diagnostic ultrasound solution for cardiologists in any clinical setting. The LISENDO 880 platform is redefining the vision for cardiac ultrasound by providing exceptional...
THE VEVO MD IS THE WORLD’S FIRST ULTRA HIGH FREQUENCY ULTRASOUND SYSTEM DESIGNED FOR CLINICAL USE WITH FREQUENCIES UP TO 70 MHz. This groundbreaking technology opens up new possibilities for medical imaging that have never been seen before. Whether...
The iViz is a lightweight Point Of Care (POC) ultrasound solution, specifically designed for emerging sub-segments where there is need for a highly accessible and mobile solution that is capable throughout key areas of the patient care path. The iViz...
The SonoSite SII features a new touchscreen user interface with a clinician-driven menu logic that adaptively adjusts to your imaging needs – “what you need, is what you see”. An embedded dual transducer connector allows you to quickly switch between...