# Intraoperative MRI and CT

Source: https://onco.cc/technologies/intraoperative-mri-ct/  
OnCo record `intraoperative-mri-ct` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Scanners built into or next to the operating theatre, so the surgeon can check during a brain tumour or spine operation how much tumour is left and remove more before closing.

## Summary

Intraoperative MRI began in 1994 with an open magnet at Brigham and Women's Hospital in which the surgeon operated between two coils. Today the usual design is a high-field magnet in an adjoining room or a ceiling-mounted magnet that travels to the patient, with the operating table and instruments made MR-compatible. Its main use is glioma surgery: a randomised trial (Senft, Lancet Oncology 2011) showed that intraoperative MRI increased the rate of complete resection of contrast-enhancing tumour compared with conventional microsurgery, and it is also used for pituitary adenomas and paediatric brain tumours. Intraoperative CT, either a mobile cone-beam or fan-beam unit (Medtronic O-arm, Brainlab Airo, Samsung BodyTom) or a fixed scanner in a hybrid theatre, updates surgical navigation after the anatomy has shifted and confirms screw and implant placement in spinal and pelvic tumour surgery.

The cost is high: a dedicated suite, compatible instruments, longer operations and staff training, and the benefit is proven only for extent of resection, not directly for survival. Fluorescence-guided surgery with 5-ALA and intraoperative ultrasound are cheaper ways of answering the same question.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-17
- Tags: machines-wave
- Principle: An MRI or CT scanner integrated with the operating suite acquires images during surgery so that residual tumour is seen and navigation is re-registered to the shifted anatomy before the operation is completed.
- Since: 1994
- Strengths: More complete glioma resection in a randomised trial; Updates navigation after brain shift; Confirms implants in spinal tumour surgery
- Limitations: Expensive suite and compatible instruments; Longer operations; No direct evidence of longer survival

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Intraoperative_MRI
- Senft et al., Intraoperative MRI guidance and extent of resection in glioma surgery (Lancet Oncology 2011): https://doi.org/10.1016/S1470-2045(11)70196-6
- Wikipedia: https://en.wikipedia.org/wiki/Intraoperative_MRI

## Connected records

- technologies: [CT (computed tomography)](https://onco.cc/technologies/ct/), [Fluorescence-guided surgery](https://onco.cc/technologies/fluorescence-guided-surgery/), [Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath)](https://onco.cc/technologies/intraoperative-fluorescence-imaging-systems/), [Laser interstitial thermal therapy (LITT)](https://onco.cc/technologies/litt/), [Laser interstitial thermal therapy systems (NeuroBlate, Visualase)](https://onco.cc/technologies/litt-systems/), [MRI](https://onco.cc/technologies/mri/), [MRI field strengths: 1.5 T, 3 T and 7 T](https://onco.cc/technologies/mri-field-strengths/), [Surgical robots: da Vinci, Hugo, Versius and single-port systems](https://onco.cc/technologies/surgical-robot-platforms/)
- cancers: [Brain and spinal cord tumours (all types)](https://onco.cc/cancers/brain-tumours/), [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Paediatric low-grade glioma](https://onco.cc/cancers/paediatric-low-grade-glioma/), [Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma](https://onco.cc/cancers/pituitary-tumours/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/)
- fronts: [Imaging](https://onco.cc/fronts/imaging/), [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- companies: [Brainlab](https://onco.cc/companies/brainlab/), [GE HealthCare](https://onco.cc/companies/ge-healthcare/), [Medtronic](https://onco.cc/companies/medtronic/), [Philips](https://onco.cc/companies/philips/), [Siemens Healthineers](https://onco.cc/companies/siemens-healthineers/)

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