A surgical guidance system is disclosed that allows for real-time imaging andpatientmonitoring during a surgical procedure. The system can include an MRI systemfor generatingreal-time images of the patient while surgery is being performed. Prior tosurgery, a surgical plancan be created using a planning interface. A control unit receives the real-time image data and thesurgical plan, and monitors the image data based on parameters included in thesurgical plan. Thecontrol-unit monitoring occurs in real-time while the surgical procedure isbeing performed. Thecontrol unit can detect deviations from the surgical plan and/or high-riskpatient conditions andinstruct an alert unit to issue an alert based on the detected conditions.