{"entity":{"id":"intraoperative-mri-ct","kind":"technology","name":"Intraoperative MRI and CT","aka":[],"tldr":"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.\n\nThe 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.","status":"established","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Intraoperative_MRI","links":[{"label":"Senft et al., Intraoperative MRI guidance and extent of resection in glioma surgery (Lancet Oncology 2011)","url":"https://doi.org/10.1016/S1470-2045(11)70196-6"},{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Intraoperative_MRI"}],"tags":["machines-wave"],"related":["mri-field-strengths","litt"],"cancers":["glioblastoma","brain-tumours","pituitary-tumours","paediatric-low-grade-glioma","sarcoma"],"sections":["imaging","surgery"],"technologies":["mri","ct","fluorescence-guided-surgery"],"targets":[],"drugs":[],"companies":["siemens-healthineers","ge-healthcare","philips","brainlab","medtronic"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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"],"since":1994},"route":"/technologies/intraoperative-mri-ct/","neighbours":{"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"fluorescence-guided-surgery","kind":"technology","name":"Fluorescence-guided surgery","route":"/technologies/fluorescence-guided-surgery/"},{"id":"intraoperative-fluorescence-imaging-systems","kind":"technology","name":"Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath)","route":"/technologies/intraoperative-fluorescence-imaging-systems/"},{"id":"litt","kind":"technology","name":"Laser interstitial thermal therapy (LITT)","route":"/technologies/litt/"},{"id":"litt-systems","kind":"technology","name":"Laser interstitial thermal therapy systems (NeuroBlate, Visualase)","route":"/technologies/litt-systems/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"},{"id":"mri-field-strengths","kind":"technology","name":"MRI field strengths: 1.5 T, 3 T and 7 T","route":"/technologies/mri-field-strengths/"},{"id":"surgical-robot-platforms","kind":"technology","name":"Surgical robots: da Vinci, Hugo, Versius and single-port systems","route":"/technologies/surgical-robot-platforms/"}],"cancer":[{"id":"brain-tumours","kind":"cancer","name":"Brain and spinal cord tumours (all types)","route":"/cancers/brain-tumours/"},{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"},{"id":"paediatric-low-grade-glioma","kind":"cancer","name":"Paediatric low-grade glioma","route":"/cancers/paediatric-low-grade-glioma/"},{"id":"pituitary-tumours","kind":"cancer","name":"Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma","route":"/cancers/pituitary-tumours/"},{"id":"sarcoma","kind":"cancer","name":"Sarcomas (soft tissue, bone, GIST)","route":"/cancers/sarcoma/"}],"section":[{"id":"imaging","kind":"section","name":"Imaging","route":"/fronts/imaging/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"company":[{"id":"brainlab","kind":"company","name":"Brainlab","route":"/companies/brainlab/"},{"id":"ge-healthcare","kind":"company","name":"GE HealthCare","route":"/companies/ge-healthcare/"},{"id":"medtronic","kind":"company","name":"Medtronic","route":"/companies/medtronic/"},{"id":"philips","kind":"company","name":"Philips","route":"/companies/philips/"},{"id":"siemens-healthineers","kind":"company","name":"Siemens Healthineers","route":"/companies/siemens-healthineers/"}]}}