東京慈恵会医科大学附属柏病院における脳腫痬に対する新たな治療戦略: 術中MRIの稼働準備から臨床応用までの道のり

摘要

悪性グリオーマは，成人の悪性脳腫瘍の中ではrn最も頻度の高い疾患である．本疾患に対しては手rn術，放射線治療と化学療法を併用する集学的治療rnが行われているが，他の悪性腫瘍とは異なり，そrnの治療成績に大きな進歩はみられていない．なかrnでも神経膠芽脛（glioblastoma；以下GBM）は平rn均余命が発症から約1年ときわめて予後不良で，rn脳神経外科領域において最も治療困難な疾患の一rnつである．%Intraoperative magnetic resonance imaging (MRI) is a novel tool for neurosurgical operations. It facilitates surgery for brain tumors, especially gliomas and pituitary adenomas. It provides much information about residual tumors, bleeding, and brain swelling during surgery and allows tumors to be resected completely and safely. Intraoperative MRI has become widely used during operations for brain tumors. An open MRI scanner for intraoperative MRI was installed at The Jikei University School of Medicine Kashiwa Hospital in September 2002, and brain tumor surgery utilizing the open MRI scanner was first performed in December 2007 for a metastatic tumor in the left temporal lobe. Since then, 6 operationsrnhave been performed, and the first trial of intraoperative MRI for brain tumor surgery was performed in January 2009. In the present manuscript, we describe the background of and future prospects for brain tumor surgery utilizing intraoperative MRI at our hospital.