Clinical and economic outcomes of low-field intraoperative MRI-guided tumor resection neurosurgery

Purpose: To compare low-field (0.15 T) intraoperative magnetic resonance imaging (iMRI)-guided tumor resection with both conventional magnetic resonance imaging (cMRI)-guided tumor resection and high-field (1.5 T) iMRI-guided resection from the clinical and economic point of view. Materials and Methods: We retrospectively compared 65 iMRI patients with 65 cMRI patients in terms of hospital length of stay, repeat resection rate, repeat resection interval, complication rate, cost to the patient, cost to the hospital, and cost effectiveness. In addition, we compared our low-field results with previously published high-field results. Results: The complication rate was lower for iMRI vs. cMRI in patients presenting for their initial tumor resection (45 vs. 57 complications, P = 0.048). The iMRI repeat resection interval was longer for this cohort (20.1 vs. 6.7 months, P = 0.020). iMRI was more cost-effective than cMRI for patients who had repeat resections ($10,690/RFY vs. $76,874/RFY, P < 0.001). We found no other clinical or economic differences between iMRI- and cMRI-guided tumor resection surgeries. Overall, we did not find the advantages to low-field iMRI that have been reported for high-field iMRI. Conclusion: There is no adequate justification for the widespread installation of low-field iMRI in its current development state.