Esaote enters the field of neurosurgery with intraoperative MRI system

Esaote debuted an innovative open MRI system at this year’s European Association of Neurosurgical Societies Annual Congress in Vienna, Austria. I-Genius is designed to provide real-time checks during glioma surgery.

Gliomas are the most common primary malignant brain tumours, accounting for about 81 per cent of malignant intracranial tumours. The most frequent
glioma sub-type, glioblastoma, represents around 45 per cent of gliomas and has a five-year survival rate of about five per cent. Surgery aims to remove as much tumour as possible, but when tumour tissue is difficult to distinguish from healthy brain tissue by the naked eye there is high risk of residual disease.

Imaging techniques are used to identify residual tumour, but once the meninges are opened, and especially during tissue removal, the brain shifts Esaote explains. This causes loss of spatial coherence between preoperative and intraoperative imaging, increasing the chance that parts of the tumour are left behind. While ultrasound and CT are used intraoperatively, ultrasound has limited field of view and CT involves repeated ionising radiation.

Although MRI avoids both limitations, Esaote says existing intraoperative MRI systems are mostly closed-magnet devices that are expensive to install and maintain, and complex for use during surgery.

Esaote’s I-Genius is an open MRI system optimised for neurosurgical use. The system includes a surgical table and accessories designed to be fully compatible with MRI use. The patient stays on the same table for the entire procedure and does not need to be moved during the operation. This makes it possible to acquire MR images during surgery, helping surgeons to confirm that the tumour has been fully removed before closing the skull.

The system was the focus of the symposium ‘Expertise meets innovation: why the I-Genius MRI solution will change neurosurgery’, hosted by Esaote. Chief of neurosurgery at Clinica Adventista Belgrano, Buenos Aires, Argentina, Dr Roberto Herrera said: “What is truly innovative about I-Genius is its ability to provide intraoperative imaging at every stage of neurosurgery. This allows the surgeon to resect the lesion, immediately verify the result, reassess how to proceed with precision and safety, and then confidently continue the procedure. This process can be repeated as many times as the surgeon deems necessary during the operation, culminating in a final check that provides the certainty of having achieved the maximum safe resection of the tumour while preserving the healthy brain and the patient’s neurological functions.”

Esaote CEO Franco Fontana commented: “With this system, we are entering the intraoperative MRI field with a solution that is both accessible and sustainable, bringing great value to daily neurosurgical practice.”

Picture: Esaote CEO Franco Fontana and the I-Genius, an open MRI system designed with neurosurgeons.

Read this report on page 10 of the January 2026 issue of RAD Magazine.