Implantation of radioactive particles into the cranial base and orbital apex with the use of a magnetic resonance imaging–based surgical navigation system

2013 ◽  
Vol 116 (6) ◽  
pp. e473-e477 ◽  
Author(s):  
Yipeng Ren ◽  
Rongfa Bu ◽  
Lei Zhang ◽  
Xuelei Huang ◽  
Yunli Li
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Navigation System ◽  
Surgical Navigation ◽  
Cranial Base ◽  
Orbital Apex ◽  
Resonance Imaging ◽  
Surgical Navigation System

Computerized Tomography and Magnetic Resonance Imaging Following Cranial Base Surgery

1991 ◽  
Vol 101 (9) ◽  
pp. 951???959 ◽  
Author(s):  
Ricardo L. Carrau ◽  
Jane L. Weissman ◽  
Ivo P. Janecka ◽  
Carl H. Snyderman ◽  
Hugh D. Curtin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Cranial Base ◽  
Resonance Imaging ◽  
Cranial Base Surgery

scholarly journals Intraoperative Real-Time Querying of White Matter Tracts During Frameless Stereotactic Neuronavigation

Neurosurgery ◽  
2011 ◽  
Vol 68 (2) ◽  
pp. 506-516 ◽  
Author(s):  
Haytham Elhawary ◽  
Haiying Liu ◽  
Pratik Patel ◽  
Isaiah Norton ◽  
Laura Rigolo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Real Time ◽  
Navigation System ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
Resonance Imaging ◽  
Surgical Tool ◽  
Tractography Data

Abstract BACKGROUND: Brain surgery faces important challenges when trying to achieve maximum tumor resection while avoiding postoperative neurological deficits. OBJECTIVE: For surgeons to have optimal intraoperative information concerning white matter (WM) anatomy, we developed a platform that allows the intraoperative real-time querying of tractography data sets during frameless stereotactic neuronavigation. METHODS: Structural magnetic resonance imaging, functional magnetic resonance imaging, and diffusion tensor imaging were performed on 5 patients before they underwent lesion resection using neuronavigation. During the procedure, the tracked surgical tool tip position was transferred from the navigation system to the 3-dimensional Slicer software package, which used this position to seed the WM tracts around the tool tip location, rendering a geometric visualization of these tracts on the preoperative images previously loaded onto the navigation system. The clinical feasibility of this approach was evaluated in 5 cases of lesion resection. In addition, system performance was evaluated by measuring the latency between surgical tool tracking and visualization of the seeded WM tracts. RESULTS: Lesion resection was performed successfully in all 5 patients. The seeded WM tracts close to the lesion and other critical structures, as defined by the functional and structural images, were interactively visualized during the intervention to determine their spatial relationships relative to the lesion and critical cortical areas. Latency between tracking and visualization of tracts was less than a second for a fiducial radius size of 4 to 5 mm. CONCLUSION: Interactive tractography can provide an intuitive way to inspect critical WM tracts in the vicinity of the surgical region, allowing the surgeon to have increased intraoperative WM information to execute the planned surgical resection.

Radioguided Improved Resection of a Cranial Base Meningioma

2009 ◽  
Vol 64 (suppl_1) ◽  
pp. ONSE84-ONSE85 ◽  
Author(s):  
Ruben Dammers ◽  
Sanford P.C. Hsu ◽  
Ali F. Krisht
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Somatostatin Receptors ◽  
Radiation Detection ◽  
Cranial Base ◽  
Neurological Deficits ◽  
Magnetic Resonance Imaging Scan ◽  
Radioguided Surgery ◽  
Resonance Imaging ◽  
Base Region

Abstract Objective: In meningioma surgery, the completeness of resection is of great importance with regard to prognosis and recurrence. This is more difficult in meningiomas en plaque and cranial base meningiomas, which often involve the bone of the cranial base. We present a case in which radioguided resection of a meningioma using 111indium-labeled somatostatin receptors enhanced the extent of the resection and describe how this could be of potential use in maximizing resection of meningiomas involving the cranial base region. Methods: A 45-year-old woman presented with a history of headache and no neurological deficits. Magnetic resonance imaging of the brain revealed a large enhancing extra-axial mass involving the left sphenoid wing region, suggestive of a meningioma. A somatostatin analog scintigram using 111In-labeled pentetreotide was obtained 24 hours preoperatively. This showed abnormal uptake in the left frontal region, consistent with a meningioma, because of the abundance and high affinity of somatostatin receptors in meningiomas. Intraoperatively, a radiation detection probe guided the resection until no gamma radiation could be discerned. Results: A postoperative magnetic resonance imaging scan and scintigram showed complete resection of the meningioma. Conclusion: Radioguided surgery of meningiomas by labeling them with 111In is an innovative and feasible approach to help guide and maximize meningioma resection, especially those involving the cranial base region. This technique should be used further and studied to achieve better resection of meningiomas in general and of those involving the cranial base in particular.

Inflammatory optic neuropathy in granulomatosis with polyangiitis can mimick isolated idiopathic optic neuritis

2019 ◽  
pp. 112067211988900
Author(s):  
Manon Clément ◽  
Antoine Néel ◽  
Frédérique Toulgoat ◽  
Michel Weber ◽  
Pascal Godmer ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Literature Review ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Granulomatosis With Polyangiitis ◽  
Orbital Apex ◽  
Resonance Imaging

Objective: We describe a clinico-radiological presentation of inflammatory optic neuropathy that mimicked optic neuritis. Methods: Retrospective single-center case series and literature review of optic neuropathy without orbital pseudotumor. Results: Five local patients fulfilled the inclusion criteria. Clinical presentation revealed rapidly progressive severe unilateral visual loss, retrobulbar pain (n = 4), and paralytic strabismus (simultaneous = 2, protracted = 2) without proptosis. Optic nerve abnormality was not appreciated on initial scan review. Patients did not have any general activity of the granulomatosis with polyangiitis. Upon follow-up magnetic resonance imaging and initial imaging review, all patients revealed orbital apex anomalies. Visual acuity improved in three patients who received high-dose intravenous glucocorticosteroids immediately. Relapse was frequent and visual outcome was poor (final vision > 20/40 in two patients only). Literature review identified 16 well-documented cases of granulomatosis with polyangiitis–related isolated optic neuropathies. Magnetic resonance imaging revealed no abnormality (n = 6), optic nerve and/or sheath involvement (n = 9), apex infiltration (n = 3), and/or pachymeningitis (n = 7). Conclusion: Granulomatosis with polyangiitis is a rare yet potentially blinding cause of inflammatory optic neuropathy. Optic neuropathy in granulomatosis with polyangiitis may occur in the absence of systemic symptoms of disease activity and is challenging to distinguish from other inflammatory and non-inflammatory disorders affecting visual acuity. Several clinical and imaging clues suggest that optic neuropathy results from the development of an extravascular granulomatous process within the optic nerve sheath in the orbital apex, a place that is difficult to image. In a granulomatosis with polyangiitis patient with unexplained visual loss and a seemingly normal workup (fundoscopy, biology, and imaging), clinician should keep a high index of suspicion.

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