Intraoperative perfusion magnetic resonance imaging: Cutting-edge improvement in neurosurgical procedures

Core Tip

Core tip: The amount of brain tumor resection is one of the prognostic factors for time to tumor progression and median survival. To achieve maximum brain tumor removal, while preventing damage to “eloquent” brain regions, a variety of technical advances have been introduced, including intraoperative magnetic resonance imaging. Brain shift can thus be compensated; however, surgically induced contrast enhancement along the rim of the resection cavity hampers interpretation of these intraoperatively acquired images. Recently, perfusion techniques (dynamic contrast enhanced magnetic resonance imaging, dynamic susceptibility contrast magnetic resonance imaging) have been introduced that can differentiate residual tumor from surgically induced changes and thus overcome this remaining uncertainty in high grade brain tumor resection.