Is intraoperative MRI use in malignant brain tumor surgery a health care burden? A matched analysis of MarketScan Database

Mayur Sharma, Dengzhi Wang, Paolo Palmisciano, Beatrice Ugiliweneza, Shiao Woo, Megan Nelson, Donald Miller, Jesse Savage, Maxwell Boakye, Norberto Andaluz, Akshitkumar M. Mistry, Clark C. Chen, Brian J. Williams

Research output: Contribution to journalArticlepeer-review


Background: Intraoperative magnetic resonance imaging (iMRI) is a useful adjunct for resection of primary malignant brain tumors (MBTs). The aim of our study is to investigate the impact of iMRI on health care utilization in patients who underwent craniotomy for resection of MBTs. Materials and methods: MarketScan database were queried using the ICD-9/10 and CPT 4th edition, from 2008 to 2020. We included patients ≥ 18 years of age who underwent a craniotomy with at-least one year follow-up. Outcomes were length of stay (LOS), discharge disposition, hospital/emergency room (ER) re-admissions, outpatient services, medication refills and corresponding payments. Results: Of 6,640 patients who underwent craniotomy for MBTs, 465 patients (7%) had iMRI used during the procedure with 0.7% per year increase in iMRI use during the study period. Patients without iMRI use had higher complications at index hospitalization compared to those with iMRI use (19% vs. 14%, p = 0.04). There was no difference in the ER admission rates among the patients who underwent surgery with and without iMRI use at 6-months and 1-year after the index procedure. In terms of post-discharge payments, no significant differences were noted among the patients without and with iMRI use at 6-months ($81,107 vs. $ 81,458, p = 0.26) and 1-year ($132,657 vs. $ 118,113, p = 0.12). Conclusion: iMRI use during craniotomy for MBT gradually increased during the study period. iMRI did not result in higher payments at index hospitalization, 6-months, and 1-year after the index procedure.

Original languageEnglish (US)
Pages (from-to)331-339
Number of pages9
JournalJournal of neuro-oncology
Issue number2
StatePublished - Nov 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Healthcare utilization
  • Intraoperative MRI
  • Malignant brain tumor
  • National database
  • Surgery


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