Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery

Abstract Preoperative balanced steady-state free precession (bSSFP) imaging is helpful in endoscopic transsphenoidal surgery (ETSS) for accurately evaluating the optic chiasm and surrounding structures. While intraoperative magnetic resonance imaging (iMRI) has been shown to improve surgical outcome...

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Main Authors: Yosuke Fujimoto, Masaaki Kohta, Yuichi Fujita, Masaaki Taniguchi, Tomoaki Nakai, Kazuhiro Tanaka, Atsushi Fujita, Eiji Kohmura, Takashi Sasayama
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11609-3
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author Yosuke Fujimoto
Masaaki Kohta
Yuichi Fujita
Masaaki Taniguchi
Tomoaki Nakai
Kazuhiro Tanaka
Atsushi Fujita
Eiji Kohmura
Takashi Sasayama
author_facet Yosuke Fujimoto
Masaaki Kohta
Yuichi Fujita
Masaaki Taniguchi
Tomoaki Nakai
Kazuhiro Tanaka
Atsushi Fujita
Eiji Kohmura
Takashi Sasayama
author_sort Yosuke Fujimoto
collection DOAJ
description Abstract Preoperative balanced steady-state free precession (bSSFP) imaging is helpful in endoscopic transsphenoidal surgery (ETSS) for accurately evaluating the optic chiasm and surrounding structures. While intraoperative magnetic resonance imaging (iMRI) has been shown to improve surgical outcomes, the utility of intraoperative contrast-enhanced bSSFP remains underexplored. This study was performed to assess the effectiveness of intraoperative contrast-enhanced bSSFP compared with T2-weighted imaging (T2WI) for visualizing the optic chiasm and to identify factors affecting image quality. This retrospective study included patients who underwent ETSS between March 2015 and March 2020, with both preoperative and intraoperative MRI, including coronal contrast-enhanced bSSFP and T2WI sequences. Two neurosurgeons independently scored optic chiasm visibility using a 4-point scale (0–3). Statistical analyses involved paired comparisons of imaging scores and assessments of factors influencing intraoperative contrast-enhanced bSSFP quality, such as intracranial air and blood in the tumor cavity.Eighteen cases were analyzed. Contrast-enhanced bSSFP scores were significantly higher than T2WI scores for both preoperative imaging (median 3.0, IQR 2.75–3.0 vs. median 2.0, IQR 1.0–2.0; p = 0.0002) and intraoperative imaging (median 3.0, IQR 2.0–3.0 vs. median 2.0, IQR 1.0–2.0; p = 0.0002). A decrease in intraoperative contrast-enhanced bSSFP scores was observed in 5 cases and was significantly associated with intracranial air (p = 0.047) but not with blood in the tumor cavity (p = 0.608). Intraoperative contrast-enhanced bSSFP was superior to T2WI for optic chiasm visualization, consistent with preoperative findings. However, intracranial air significantly degraded the image quality of contrast-enhanced bSSFP.
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spelling doaj-art-dd28f1a7802a4ec59a7208f755d05a312025-08-20T04:01:51ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-11609-3Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgeryYosuke Fujimoto0Masaaki Kohta1Yuichi Fujita2Masaaki Taniguchi3Tomoaki Nakai4Kazuhiro Tanaka5Atsushi Fujita6Eiji Kohmura7Takashi Sasayama8Department of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineDepartment of Neurosurgery, Kobe University Graduate School of MedicineAbstract Preoperative balanced steady-state free precession (bSSFP) imaging is helpful in endoscopic transsphenoidal surgery (ETSS) for accurately evaluating the optic chiasm and surrounding structures. While intraoperative magnetic resonance imaging (iMRI) has been shown to improve surgical outcomes, the utility of intraoperative contrast-enhanced bSSFP remains underexplored. This study was performed to assess the effectiveness of intraoperative contrast-enhanced bSSFP compared with T2-weighted imaging (T2WI) for visualizing the optic chiasm and to identify factors affecting image quality. This retrospective study included patients who underwent ETSS between March 2015 and March 2020, with both preoperative and intraoperative MRI, including coronal contrast-enhanced bSSFP and T2WI sequences. Two neurosurgeons independently scored optic chiasm visibility using a 4-point scale (0–3). Statistical analyses involved paired comparisons of imaging scores and assessments of factors influencing intraoperative contrast-enhanced bSSFP quality, such as intracranial air and blood in the tumor cavity.Eighteen cases were analyzed. Contrast-enhanced bSSFP scores were significantly higher than T2WI scores for both preoperative imaging (median 3.0, IQR 2.75–3.0 vs. median 2.0, IQR 1.0–2.0; p = 0.0002) and intraoperative imaging (median 3.0, IQR 2.0–3.0 vs. median 2.0, IQR 1.0–2.0; p = 0.0002). A decrease in intraoperative contrast-enhanced bSSFP scores was observed in 5 cases and was significantly associated with intracranial air (p = 0.047) but not with blood in the tumor cavity (p = 0.608). Intraoperative contrast-enhanced bSSFP was superior to T2WI for optic chiasm visualization, consistent with preoperative findings. However, intracranial air significantly degraded the image quality of contrast-enhanced bSSFP.https://doi.org/10.1038/s41598-025-11609-3Intraoperative magnetic resonance imagingBalanced steady-state free precessionEndoscopic transsphenoidal surgeryOptic chiasm
spellingShingle Yosuke Fujimoto
Masaaki Kohta
Yuichi Fujita
Masaaki Taniguchi
Tomoaki Nakai
Kazuhiro Tanaka
Atsushi Fujita
Eiji Kohmura
Takashi Sasayama
Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery
Scientific Reports
Intraoperative magnetic resonance imaging
Balanced steady-state free precession
Endoscopic transsphenoidal surgery
Optic chiasm
title Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery
title_full Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery
title_fullStr Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery
title_full_unstemmed Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery
title_short Enhanced intraoperative visualization of the optic chiasm using contrast-enhanced balanced steady-state free precession imaging during endoscopic transsphenoidal surgery
title_sort enhanced intraoperative visualization of the optic chiasm using contrast enhanced balanced steady state free precession imaging during endoscopic transsphenoidal surgery
topic Intraoperative magnetic resonance imaging
Balanced steady-state free precession
Endoscopic transsphenoidal surgery
Optic chiasm
url https://doi.org/10.1038/s41598-025-11609-3
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