{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:40:10Z","timestamp":1793274010350,"version":"4.5.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,3]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Endoscopic skull base surgery has become increasingly popular among the skull base surgery community, with improved illumination and angled visualization potentially improving tumor resection rates. Intraoperative MRI (iMRI) is used to detect residual disease during the course of the resection. This study is an investigation of the utility of 3-T iMRI in combination with transnasal endoscopy with regard to gross-total resection (GTR) of pituitary macroadenomas.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors retrospectively reviewed all endoscopic transsphenoidal operations performed in the Advanced Multimodality Image Guided Operating (AMIGO) suite from November 2011 to December 2014. Inclusion criteria were patients harboring presumed pituitary macroadenomas with optic nerve or chiasmal compression and visual loss, operated on by a single surgeon.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of the 27 patients who underwent transsphenoidal resection in the AMIGO suite, 20 patients met the inclusion criteria. The endoscope alone, without the use of iMRI, would have correctly predicted extent of resection in 13 (65%) of 20 cases. Gross-total resection was achieved in 12 patients (60%) prior to MRI. Intraoperative MRI helped convert 1 STR and 4 NTRs to GTRs, increasing the number of GTRs from 12 (60%) to 16 (80%).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Despite advances in visualization provided by the endoscope, the incidence of residual disease can potentially place the patient at risk for additional surgery. The authors found that iMRI can be useful in detecting unexpected residual tumor. The cost-effectiveness of this tool is yet to be determined.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.1.focus15515","type":"journal-article","created":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T03:37:27Z","timestamp":1456803447000},"page":"E18","source":"Crossref","is-referenced-by-count":59,"title":["The utility of high-resolution intraoperative MRI in endoscopic transsphenoidal surgery for pituitary macroadenomas: early experience in the Advanced Multimodality Image Guided Operating suite"],"prefix":"10.3171","volume":"40","author":[{"given":"Hasan A.","family":"Zaidi","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"De Los Reyes","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garni","family":"Barkhoudarian","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary N.","family":"Litvack","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenya Linda","family":"Bi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordina","family":"Rincon-Torroella","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Mukundan","sequence":"additional","affiliation":[{"name":"Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15515","series-title":"J Endocrinol Invest","first-page":"787","article-title":"Determinants of neurosurgical outcome in pituitary tumors","volume":"28","author":"Barahona","year":"2005"},{"issue":"4","key":"b2-focus15515","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Intraoperative magnetic resonance imaging-assisted transsphenoidal pituitary surgery in patients with acromegaly","volume":"29","author":"Bellut","year":"2010"},{"key":"b3-focus15515","series-title":"Acta Neurochir (Wien)","first-page":"639","article-title":"Intraoperative MRI and endocrinological outcome of transsphenoidal surgery for non-functioning pituitary adenoma","volume":"154","author":"Berkmann","year":"2012"},{"key":"b4-focus15515","series-title":"J Neurosurg","first-page":"518","article-title":"Intraoperative magnetic resonance imaging and early prognosis for vision after transsphenoidal surgery for sellar lesions","volume":"115","author":"Berkmann","year":"2011"},{"key":"b5-focus15515","series-title":"Neurosurgery","first-page":"1133","article-title":"Intraoperative magnetic resonance imaging to determine the extent of resection of pituitary macroadenomas during transsphenoidal microsurgery","volume":"49","author":"Bohinski","year":"2001"},{"key":"b6-focus15515","series-title":"Endocrine","first-page":"483","article-title":"Intraoperative magnetic resonance imaging during surgery for pituitary adenomas: pros and cons","volume":"42","author":"Buchfelder","year":"2012"},{"key":"b7-focus15515","series-title":"Neurosurgery","first-page":"717","article-title":"Microsurgical anatomy of the diaphragma sellae and its role in directing the pattern of growth of pituitary adenomas","volume":"62","author":"Campero","year":"2008"},{"key":"b8-focus15515","series-title":"Laryngoscope","first-page":"914","article-title":"Transnasal-transsphenoidal endoscopic surgery of the pituitary gland","volume":"106","author":"Carrau","year":"1996"},{"key":"b9-focus15515","series-title":"Surg Neurol","first-page":"336","article-title":"Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: a retrospective comparison with traditional transsphenoidal microsurgery in the same institution","volume":"72","author":"D'Haens","year":"2009"},{"key":"b10-focus15515","series-title":"Neurosurgery","first-page":"272","article-title":"Feasibility of Polestar N20, an ultra-low-field intraoperative magnetic 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Endoscopy versus MR imaging","volume":"112","author":"Jane","year":"2010"},{"key":"b14-focus15515","series-title":"Neurosurgery","first-page":"435","article-title":"Pituitary surgery: transsphenoidal approach","volume":"51","author":"Jane","year":"2002"},{"issue":"5","key":"b15-focus15515","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Intraoperative magnetic resonance imaging in pituitary macroadenoma surgery: an assessment of visual outcome","volume":"23","author":"Jones","year":"2007"},{"key":"b16-focus15515","series-title":"Neurol Med Chir (Tokyo)","first-page":"91","article-title":"Supradiaphragmatic pituitary adenoma removed through the trans-tuberculum sellae approach. 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Neurosurg","first-page":"582","article-title":"Transsphenoidal hypophysectomy","volume":"34","author":"Hardy","year":"1971"},{"key":"b13-focus15515","series-title":"J Neurosurg","first-page":"734","article-title":"Editorial. 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