Abstract
Background Setting up of a new “nearby” operation room type intraoperative magnetic resonance
imaging (iMRI) unit poses a unique set of challenges to the operating team. We describe
here an account of our experiences and a step by step protocol designed by us and
followed to troubleshoot the issues encountered. The primary objective of the study
was to observe our learning curve in the process of setting up of a new iMRI unit.
The secondary objectives were to look at the number of residues detected, quality
of imaging, and complications during iMRI.
Materials and Methods An observational study was conducted over a 3-month period involving cases requiring
iMRI. Initially, a simulation was performed using healthy volunteers, which helped
in developing a systematic protocol and drafting checklists to ensure a smooth workflow
pattern. Data collection included details regarding hindrances encountered, how these
were tackled, iMRI details (residual tumor, re-surgery), and complications, if any.
Results A total of 53 cases underwent iMRI in the study period. Among these, 51 were tumor
cases that revealed residue (detected in 28 [54.9%] cases), and re-surgery for further
resection was performed in 21/28 (75%) cases. A very high level of surgeons’ satisfaction
regarding image quality of intraoperative scan was recorded (45/53 [84%]). The number
of personnel required for shifting and shifting times could be reduced with efficient
utilization of the checklist.
Conclusion A methodical approach to tackle impediments while setting up a new unit such as iMRI
facilitates its smooth functioning and ensures minimal interruptions and evades undue
complications.
Keywords
intraoperative magnetic resonance imaging - operating room magnetic resonance imaging
- image-guided neurosurgery
