ABSTRACT
Background: Intraoperative imaging had become one of the most significant assets of modern neurosurgery, which led to even higher level of surgical accuracy for surgeon performing complex s. Traditional methods were previously restricted by the fact that it had not been possible to evaluate tumor resection, vessel integrity, or nerve structure preservation on a real-time basis. Use of newer imaging modalities like iMRI, CT and ultrasound had also been added in the recent times to improve surgical precision, reduce complication and improve overall outcome.
Objective: The objective of this study was to explore the influence of intraoperative imaging on surgical outcomes in neurosurgery with respect to resection, complication and recovery.
Methods: This prospective observational study was done at the Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from March 2024 to February 2025. Methods — Eighty patients undergoing neurosurgical procedures with a need for intraoperative imaging were studied. Patients were chosen based on their clinical diagnosis and indication for the surgery. Depending on the need, imaging based on iMRI [1], intraoperative CT, and ultrasound had been employed in surgery. Intraoperative findings such as the extent of resection, surgery time, post-operative complications, and neurological outcomes were recorded and analyzed accordingly.
Results: The results also showed that intraoperative imaging changes surgical outcomes. When intraoperative imaging was utilized, 70% of patients had complete tumor resection achieved as opposed to 52% in cases where imaging was not employed. By using imaging guidance, they were able to reduce postoperative complication rates to 12%, whilst imaging-free cases had described a complication rate of 22%. In addition, early recognition of residual tumor tissue and also intraoperative hemorrhage, which intraoperative imaging had contributed, enabled rapid correction and avoidance of postoperative morbidity. Patients who were operated on with intraoperative imaging have previously demonstrated better neurological recovery and reduced hospital stays.
Conclusion: It was concluded that intraoperative imaging significantly improves outcomes with neurosurgery through more accurate surgical targeting, fewer complications, and faster recoveries. Integration, its use into routine neurosurgical practice, has been associated with enhanced resection and safety profiles and has proven that it is fundamental for the advancement of modern neurosurgery.
Keywords: Intraoperative imaging, neurosurgery, intraoperative MRI, surgical outcomes, tumor resection, postoperative complications.