Intra-operative or post-operative MRI for gliomas

Measure purpose: Ensure MRI completed in a timely manner.

The numerator: patients who had a post-operative gadolinium-enhanced MRI of the brain or an intra-operative MRI of the brain with or without gadolinium

is divided by

The denominator: all patients >18 years and older with a diagnosis of grade III-IV glioma who undergo a surgical resection.

Exclusions are removed from the denominator:

• Patients with a contraindication for MRI (that is the presence of a pacemaker, intracranial metal clip, metallic body in the eye, or neurostimulator).
• Patients with a contraindication for receiving gadolinium.
• Patients who undergo surgery for purposes other than cytoreduction (that is diagnostic biopsy only).

Key Phrases

Examples of key phrases you could use to meet the measure include:

• Intra-operative MRI completed
• Post-operative MRI completed
• MRI contraindication present

Measure Calculation Example

Dr. Lu has 100 patients between January 1 and December 31 that underwent a surgical resection and had a diagnosis of grade III-IV glioma. Five patients were under the age of 18. This is the denominator.

Of the 95 patients who had a diagnosis of grade III-IV glioma and underwent a surgical resection, ten met exclusion criteria.  Three patients had an MRI contraindication (e.g., pacemaker or neurostimulator) and seven had surgery for diagnostic biopsy.

Of the now 85 patients that still qualify for this measure, 40 had a post-operative or intra-operative MRI.  This is the numerator.

Quality of patient care = 40/(95-10). Dr. Lu has a score of 47% for this measure.