scholarly journals Corrigendum to “Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery”

2019 ◽  
Vol 2019 ◽  
pp. 1-1
Author(s):  
Siming Bayer ◽  
Andreas Maier ◽  
Martin Ostermeier ◽  
Rebecca Fahrig
Keyword(s):  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Imaging Modalities ◽  
Brain Shift

scholarly journals Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-18 ◽  
Author(s):  
Siming Bayer ◽  
Andreas Maier ◽  
Martin Ostermeier ◽  
Rebecca Fahrig
Keyword(s):  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Imaging Systems ◽  
Imaging Modalities ◽  
Neurosurgical Procedures ◽  
Brain Shift ◽  
Web Tool ◽  
Modeling Methods ◽  
Image Guided ◽  
Tissue Manipulation

Intraoperative brain shift during neurosurgical procedures is a well-known phenomenon caused by gravity, tissue manipulation, tumor size, loss of cerebrospinal fluid (CSF), and use of medication. For the use of image-guided systems, this phenomenon greatly affects the accuracy of the guidance. During the last several decades, researchers have investigated how to overcome this problem. The purpose of this paper is to present a review of publications concerning different aspects of intraoperative brain shift especially in a tumor resection surgery such as intraoperative imaging systems, quantification, measurement, modeling, and registration techniques. Clinical experience of using intraoperative imaging modalities, details about registration, and modeling methods in connection with brain shift in tumor resection surgery are the focuses of this review. In total, 126 papers regarding this topic are analyzed in a comprehensive summary and are categorized according to fourteen criteria. The result of the categorization is presented in an interactive web tool. The consequences from the categorization and trends in the future are discussed at the end of this work.

scholarly journals Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions

2001 ◽  
Vol 10 (2) ◽  
pp. 1-5 ◽  
Author(s):  
Volker M. Tronnier ◽  
Matteo M. Bonsanto ◽  
Andreas Staubert ◽  
Michael Knauth ◽  
Stefan Kunze ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Lesion Detection ◽  
Imaging Modalities ◽  
Attractive Alternative ◽  
Low Grade ◽  
Resection Control ◽  
Low Field ◽  
Supratentorial Gliomas

Object The authors undertook a study to compare two intraoperative imaging modalities, low-field magnetic resonance (MR) imaging and a prototype of a three-dimensional (3D)–navigated ultrasonography in terms of imaging quality in lesion detection and intraoperative resection control. Methods Low-field MR imaging was used for intraoperative resection control and update of navigational data in 101 patients with supratentorial gliomas. Thirty-five patients with different lesions underwent surgery in which the prototype of a 3D-navigated ultrasonography system was used. A prospective comparative study of both intraoperative imaging modalities was initiated with the first seven cases presented here. In 35 patients (70%) in whom ultrasonography was performed, accurate tumor delineation was demonstrated prior to tumor resection. In the remaining 30% comparison of preoperative MR imaging data and ultrasonography data allowed sufficient anatomical localization to be achieved. Detection of metastases and high-grade gliomas and intra-operative delineation of tumor remnants were comparable between both imaging modalities. In one case of a low-grade glioma better visibility was achieved with ultrasonography. However, intraoperative findings after resection were still difficult to interpret with ultrasonography alone most likely due to the beginning of a learning curve. Conclusions Based on these preliminary results, intraoperative MR imaging remains superior to intraoperative ultrasonography in terms of resection control in glioma surgery. Nevertheless, the different features (different planes of slices, any-plane slicing, and creation of a 3D volume and matching of images) of this new ultrasonography system make this tool a very attractive alternative. The intended study of both imaging modalities will hopefully allow a comparison regarding sensitivity and specificity of intraoperative tumor remnant detection, as well as cost effectiveness.

Intraoperative magnetic resonance imaging during transsphenoidal surgery

2001 ◽  
Vol 95 (3) ◽  
pp. 381-390 ◽  
Author(s):  
Rudolf Fahlbusch ◽  
Oliver Ganslandt ◽  
Michael Buchfelder ◽  
Werner Schott ◽  
Christopher Nimsky
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Early Stage ◽  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Tumor Removal ◽  
Content Type ◽  
Early Evaluation ◽  
Flexible Coil ◽  
Fine Print

Object. The aim of this study was to evaluate whether intraoperative magnetic resonance (MR) imaging can increase the efficacy of transsphenoidal microsurgery, primarily in non—hormone-secreting intra- and suprasellar pituitary macroadenomas. Methods. Intraoperative imaging was performed using a 0.2-tesla MR imager, which was located in a specially designed operating room. The patient was placed supine on the sliding table of the MR imager, with the head placed near the 5-gauss line. A standard flexible coil was placed around the patient's forehead. Microsurgery was performed using MR-compatible instruments. Image acquisition was started after the sliding table had been moved into the center of the magnet. Coronal and sagittal T1-weighted images each required over 8 minutes to acquire, and T2-weighted images were obtained optionally. To assess the reliability of intraoperative evaluation of tumor resection, the intraoperative findings were compared with those on conventional postoperative 1.5-tesla MR images, which were obtained 2 to 3 months after surgery. Among 44 patients with large intra- and suprasellar pituitary adenomas that were mainly hormonally inactive, intraoperative MR imaging allowed an ultra-early evaluation of tumor resection in 73% of cases; such an evaluation is normally only possible 2 to 3 months after surgery. A second intraoperative examination of 24 patients for suspected tumor remnants led to additional resection in 15 patients (34%). Conclusions. Intraoperative MR imaging undoubtedly offers the option of a second look within the same surgical procedure, if incomplete tumor resection is suspected. Thus, the rate of procedures during which complete tumor removal is achieved can be improved. Furthermore, additional treatments for those patients in whom tumor removal was incomplete can be planned at an early stage, namely just after surgery.

A Novel Platform for Image-guided Ultrasound

Neurosurgery ◽  
2006 ◽  
Vol 58 (4) ◽  
pp. 710-718 ◽  
Author(s):  
Wuttipong Tirakotai ◽  
Dorothea Miller ◽  
Stefan Heinze ◽  
Ludwig Benes ◽  
Helmut Bertalanffy ◽  
...  
Keyword(s):  
Navigation System ◽  
Imaging Modality ◽  
Intraoperative Imaging ◽  
Intraoperative Ultrasound ◽  
Image Data ◽  
Cost Effective ◽  
Present System ◽  
Data Sets ◽  
Brain Shift ◽  
Ultrasound Device

Abstract OBJECTIVE: The combination of classic neuronavigation and intraoperative ultrasound is a recent innovation in image guidance technology. However, this technique requires two hardware components (neuronavigation and an ultrasound system). It was the aim of the study to describe a new simplified technology of a so-called one-platform navigation system developed by our institution in collaboration with the industry and to demonstrate its range of various applications. METHODS: An ultrasound device (IGSonic; BrainLAB, Munich, Germany) is integrated into the VectorVision2 navigation system (BrainLAB, Munich, Germany). The IGSonic Probe 10V5 is connected to the VectorVision Navigation station via an IGSonic Device Box. Once the ultrasound probe is calibrated, the navigated ultrasound displays the sonographic image of the intracranial anatomy on the navigation screen in a composed overlay fashion. It might depict vascular structures within the ultrasound plane by a duplex mode. Ultrasound can also be operated independently from navigation. RESULTS: The VectorVision2 system combines intraoperative ultrasound data sets with preoperatively acquired neuronavigation data sets in plug and play fashion. The system provides a cost-effective intraoperative imaging modality that offers a good anatomic orientation by various composite images, including the display of the amount of brain shift. In our institution, the comprehensible interface led to a routine use of the technology by several neurosurgeons who had not been familiar with the ultrasound technology before. CONCLUSION: The integration of an ultrasound device into an existing navigation system has been successfully developed. The system offers a friendly user interface and cost-effective intraoperative imaging feedback. Although brain shift can be visualized by an image overlay technology as demonstrated by the present system, future developments should aim at fusion techniques of both intra- and preoperative image data sets.

Intensity-based determination of high-dimensional transformations: Applications to brain lesions, brain shift and tumor resection

NeuroImage ◽  
2000 ◽  
Vol 11 (5) ◽  
pp. S626
Author(s):  
T. Schormann ◽  
S. Henn ◽  
R. Kleiser ◽  
P. Stoerig ◽  
K. Zilles
Keyword(s):  
Tumor Resection ◽  
Brain Lesions ◽  
High Dimensional ◽  
Brain Shift

Intracranial navigation by using low-field intraoperative magnetic resonance imaging: preliminary experience

2002 ◽  
Vol 97 (5) ◽  
pp. 1115-1124 ◽  
Author(s):  
Andrew A. Kanner ◽  
Michael A. Vogelbaum ◽  
Marc R. Mayberg ◽  
Joseph P. Weisenberger ◽  
Gene H. Barnett
Keyword(s):  
Magnetic Resonance ◽  
Imaging System ◽  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Cortical Mapping ◽  
Subtotal Resection ◽  
Neurosurgical Procedures ◽  
Content Type ◽  
Low Field ◽  
Fine Print

Object. Intracranial navigation by using intraoperative magnetic resonance (iMR) imaging allows the surgeon to reassess anatomical relationships in near—real time during brain tumor surgery. The authors report their initial experience with a novel neuronavigation system coupled to a low-field iMR imaging system. Methods. Between October 2000 and December 2001, 70 neurosurgical procedures were performed using the mobile 0.12-tesla PoleStar N-10 iMR imaging system. The cases included 38 craniotomies, 15 brain biopsies, nine transsphenoidal approaches, and one drainage of a subdural hematoma. Tumor resection was performed using the awake method in seven of 38 cases. Of the craniotomies, image-confirmed complete or radical tumor resection was achieved in 28 cases, subtotal resection in eight cases, and open biopsies in two cases. Tumor resection was controlled with the use of image guidance until the final intraoperative images demonstrated that there was no residual tumor or that no critical brain tissue was at risk of compromise. In each stereotactic biopsy the location of the biopsy needle could be verified by intraoperative imaging and diagnostic tissue was obtained. Complications included a case of aseptic meningitis after a biopsy and one case of temporary intraoperative failure of the anesthesia machine. Awake craniotomies were performed successfully with no permanent neurological complications. Conclusions. Intraoperative MR image—based neuronavigation is feasible when using the Odin PoleStar N-10 system for tumor resections that require multiple other surgical adjuncts including awake procedures, cortical mapping, monitoring of somatosensory evoked potentials, or electrocorticography. Use of the system for brain biopsies offers the opportunity of immediate verification of the needle tip location. Standard neurosurgical drills, microscopes, and other equipment can be used safely in conjunction with this iMR imaging system.

scholarly journals Intraoperative imaging based on common-path time-domain reflectometry for brain tumor surgery

2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Jae-Ho Han ◽  
Jaepyeong Cha
Keyword(s):  
Brain Tumor ◽  
Real Time ◽  
Time Domain ◽  
Near Infrared ◽  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Time Domain Reflectometry ◽  
Optical Path ◽  
Fiber Probe ◽  
Common Path

Minimally invasive intraoperative imaging plays a crucial role in delicate microsurgeries for precise operation monitoring in which fiber optic imaging can be considered as an endoscopy and surgical proximity guidance tool due to its compactness. This paper presents a near-infrared time-domain reflectometric common-path optical coherence tomography imaging technique using a bare-fiber probe mounted directly on a scanning galvanometer. The common-path setup allows the use of a freely adjustable optical path length and a disposable fiber probe, as well as eliminating the need for an additional dedicated reference optical path. Experimental results demonstrate clear discrimination between the brain tumor tissue and the normal tissue for mouse brains with the images acquired in real-time over a wide area. The proposed method enables real-time and in situ visualization of tumor resection for intraoperative imaging, and this study demonstrates the feasibility of its application to microsurgical interventions.

FLAIRectomy in Supramarginal Resection of Glioblastoma Correlates With Clinical Outcome and Survival Analysis: A Prospective, Single Institution, Case Series

2020 ◽  
Author(s):  
Francesco Certo ◽  
Roberto Altieri ◽  
Massimiliano Maione ◽  
Claudio Schonauer ◽  
Giuseppe Sortino ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Dna Methyltransferase ◽  
Aminolevulinic Acid ◽  
Intraoperative Imaging ◽  
Tumor Resection ◽  
Case Series ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Volumetric Analysis ◽  
Mr Images

Abstract Background Extent of tumor resection (EOTR) in glioblastoma surgery plays an important role in improving survival. Objective To analyze the efficacy, safety and reliability of fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images used to guide glioblastoma resection (FLAIRectomy) and to volumetrically measure postoperative EOTR, which was correlated with clinical outcome and survival. Methods A total of 68 glioblastoma patients (29 males, mean age 65.8) were prospectively enrolled. Hyperintense areas on FLAIR images, surrounding gadolinium-enhancing tissue on T1-weighted MR images, were screened for signal changes suggesting tumor infiltration and evaluated for supramaximal resection. The surgical protocol included 5-aminolevulinic acid (5-ALA) fluorescence, neuromonitoring, and intraoperative imaging tools. 5-ALA fluorescence intensity was analyzed and matched with the different sites on navigated MR, both on postcontrast T1-weighted and FLAIR images. Volumetric evaluation of EOTR on T1-weighted and FLAIR sequences was compared. Results FLAIR MR volumetric evaluation documented larger tumor volume than that assessed on contrast-enhancing T1 MR (72.6 vs 54.9 cc); residual tumor was seen in 43 patients; postcontrast T1 MR volumetric analysis showed complete resection in 64 cases. O6-methylguanine-DNA methyltransferase promoter was methylated in 8/68 (11.7%) cases; wild type Isocytrate Dehydrogenase-1 (IDH-1) was found in 66/68 patients. Progression free survival and overall survival (PFS and OS) were 17.43 and 25.11 mo, respectively. Multiple regression analysis showed a significant correlation between EOTR based on FLAIR, PFS (R2 = 0.46), and OS (R2 = 0.68). Conclusion EOTR based on FLAIR and 5-ALA fluorescence is feasible. Safety of resection relies on the use of neuromonitoring and intraoperative multimodal imaging tools. FLAIR-based EOTR appears to be a stronger survival predictor compared to gadolinium-enhancing, T1-based resection.

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