Brain magnetic resonance elastography (MRE) imaging, showed the precise firmness of her tumor. New slip interface imaging further revealed how attached the tumor was to normal brain tissue — even before starting surgery. The imaging techniques, invented and available only at Mayo Clinic, show whether the tumor is soft and can be removed easily, or if it is firm, making surgery more challenging and time consuming.

“Brain magnetic resonance elastography and slip interface imaging help avoid surprises in surgery that could lead to complications for the patient,” says Jamie Van Gompel, MD, a neurosurgeon at Mayo Clinic. “Once in surgery, we may find a tumor is stiffer than expected and will take more time to remove than we had planned, or alternatively, we may find the tumor to be more adherent to brain than anticipated, raising the risk of a complication from that surgery.”

Slip interface imaging provides information on the interface between the tumor boundary and surrounding tissue. This interface can be capsule–like in which the tumor slides or slips within the surrounding normal tissue, or it can form a rigid connection in which the tumor is fixed to the surrounding tissue. Surgeons use the images to plan the proper time and the safest method for extraction.

“This technology allows us to get a feel for the tumor without opening someone’s head and this will really impact patient safety,” says Dr. Van Gompel.

New Mayo Clinic research, published in the Journal of Magnetic Resonance Imaging, confirms the effectiveness of slip interface imaging. The study looked at the level of tumor adhesion in 25 patients. The brain magnetic resonance elastography and slip interface imaging showed 16 patients had tumors that could be easily removed; nine patients had tumors with adhesion to the brain; and six were mixed. Physicians found all the pre–surgical images to be an accurate assessment of the tumors and therefore an invaluable surgical planning tool.

“Slip interface imaging gives Mayo Clinic physicians new information that allows an individualized approach to tumor surgery for both cancerous and noncancerous lesions. If a tumor is soft, it can sometimes be sucked out. If it is firm, it may need ultrasonic extraction. Before we had this imaging capability, it was not uncommon to find unexpected risks that required follow up surgery,” says John Huston III, MD, a radiologist who helped develop the imaging technology.