Is intraoperative MR-guided surgery of value?

Is intraoperative MR-guided surgery of value?

Editorial Is Intraoperative MR-guided Surgery of Value? quipment manufacturers are promoting the use of intraoperative magnetic resonance (MR) to en...

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Editorial

Is Intraoperative MR-guided Surgery of Value?

quipment manufacturers are promoting the use of intraoperative magnetic resonance (MR) to enable the surgeon to achieve a more complete tumor removal. At this time, I know of no study that has shown that the more extensive removal (if it occurs) has translated into increased survival. Almost 40 years ago, when I was at the National Cancer Institute, the logs of tumor cells necessary to form a 100-gram tumor were 1011 or 1012. To reduce the mass to 1 gram, only 2 logs of cells would be removed, leaving 9 logs to continue growing. Even if MR technology could allow removal of one more log of cells—which is doubtful—

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most of the tumor would still remain. To me, this mathematical evaluation indicates that the technology is irrelevant to curing this disease. We did investigate the possibility of purchasing this equipment for our institution, but we decided that the costs involved in the purchase and in the technical staff necessary to run it were unlikely to be regained by increased numbers of patients. What we need are some objective reports on this subject. James I. Ausman, M.D., Ph.D Editor

hree-quarters of all doctors 39 or under buy term [life insurance] coverage, which has no investment component, but some do favor cash-buildup insurance, such as variable life and variable annuities. More than 50% of young physicians have $500,000 or more in life insurance coverage.

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—Brad Burg, “Young doctors face a steep climb” “Medical Economics,” August 20, 2001

0090-3019/01/$–see front matter PII S0090-3019(01)00588-2

© 2001 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010