Lead Optimization of Nerve-Specific Fluorophores for Image-Guided Nerve Sparing Surgical Procedures

2021 ◽  
Author(s):  
Connor W. Barth ◽  
Lei G. Wang ◽  
Antonio Montano ◽  
Alexander L. Antaris ◽  
Alwin Klaassen ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Lead Optimization ◽  
Nerve Sparing ◽  
Image Guided

Pharmacology of near infrared nerve-specific fluorophores for fluorescence-guided nerve sparing surgical procedures

2021 ◽  
Author(s):  
Connor W. Barth ◽  
Lei G. Wang ◽  
Antonio Montaño ◽  
Alexander L. Antaris ◽  
Jonathan M. Sorger ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Near Infrared ◽  
Nerve Sparing

scholarly journals Model of Surgical Procedures for Multimodal Image-Guided Neurosurgery

2003 ◽  
Vol 8 (2) ◽  
pp. 98-106 ◽  
Author(s):  
P. Jannin ◽  
M. Raimbault ◽  
X. Morandi ◽  
L. Riffaud ◽  
B. Gibaud
Keyword(s):  
Surgical Procedures ◽  
Image Guided

Radiosurgery for Trigeminal Neuralgia

2018 ◽  
pp. 187-215
Author(s):  
Daivik B. Vyas ◽  
Lily H. Kim ◽  
Allen Ho ◽  
Eric S. Sussman ◽  
Arjun V. Pendharkar ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Trigeminal Nerve ◽  
Treatment Modality ◽  
Clinical Utility ◽  
Treatment Protocol ◽  
Low Risk ◽  
Image Guided ◽  
Symptomatic Management

Trigeminal neuralgia is a debilitating neuropathic condition characterized by recurrent paroxysms of shock-like pain across the distribution of the trigeminal nerve, often brought on by innocuous stimuli. Available therapies presently include symptomatic management using anti-convulsant drugs and invasive surgical procedures to target the pathogenic drivers of disease or ablate the trigeminal nerve. Radiosurgery is a treatment modality that offers a minimally invasive, low-risk alternative that has promising clinical utility in the management of refractory trigeminal neuralgia. Radiosurgical approaches like Gamma Knife (GKS) and Cyberknife (CK) utilize image-guided, algorithm-defined dose contouring to disrupt pathogenic pain signaling by delivering targeted amounts of radiation along different points on the trigeminal nerve. This chapter reviews the structure of radiotherapy paradigms, treatment protocol, major outcomes, associated risks, relative clinical utility, and areas of further research that underlie the use of CK and GKS in managing trigeminal neuralgia.

Glioma Resection in a Shared-resource Magnetic Resonance Operating Room after Optimal Image-guided Frameless Stereotactic Resection

Neurosurgery ◽  
2001 ◽  
Vol 48 (4) ◽  
pp. 731-744 ◽  
Author(s):  
Ronald E. Warnick ◽  
Mary F. Gaskill-Shipley ◽  
Donald W. Kormos ◽  
Robert R. Lukin ◽  
John M. Tew
Keyword(s):  
Magnetic Resonance ◽  
Diagnostic Imaging ◽  
Surgical Procedures ◽  
Intraoperative Mri ◽  
World Health ◽  
Shared Resource ◽  
Image Guided ◽  
Postoperative Mri ◽  
Mri Studies ◽  
Glioma Resection

Abstract OBJECTIVE We describe a shared-resource intraoperative magnetic resonance imaging (MRI) design that allocates time for both surgical procedures and routine diagnostic imaging. We investigated the safety and efficacy of this design as applied to the detection of residual glioma immediately after an optimal image-guided frameless stereotactic resection (IGFSR). METHODS Based on the twin operating rooms (ORs) concept, we installed a commercially available Hitachi AIRIS II, 0.3-tesla, vertical field, open MRI unit in its own specially designed OR (designated the magnetic resonance OR) immediately adjacent to a conventional neurosurgical OR. Between May 1998 and October 1999, this facility was used for both routine diagnostic imaging (969 diagnostic scans) and surgical procedures (50 craniotomies for tumor resection, 27 transsphenoidal explorations, and 5 biopsies). Our study group, from which prospective data were collected, consisted of 40 of these patients who had glioma (World Health Organization Grades II–IV). These 40 patients first underwent optimal IGFSRs in the adjacent conventional OR, where resection continued until the surgeon believed that all of the accessible tumor had been removed. Patients were then transferred to the magnetic resonance OR to check the completeness of the resection. If accessible residual tumor was observed, then a biopsy and an additional resection were performed. To validate intraoperative MRI findings, early postoperative MRI using a 1.5-tesla magnet was performed. RESULTS Intraoperative images that were suitable for interpretation were obtained for all 40 patients after optimal IGFSRs. In 19 patients (47%), intraoperative MRI studies confirmed that adequate resection had been achieved after IGFSR alone. Intraoperative MRI studies showed accessible residual tumors in the remaining 21 patients (53%), all of whom underwent additional resections. Early postoperative MRI studies were obtained in 39 patients, confirming that the desired final extent of resection had been achieved in all of these patients. One patient developed a superficial wound infection, and no hazardous equipment or instrumentation problems occurred. CONCLUSION Use of an intraoperative MRI facility that permits both diagnostic imaging and surgical procedures is safe and may represent a more cost-effective approach than dedicated intraoperative units for some hospital centers. Although we clearly demonstrate an improvement in volumetric glioma resection as compared with IGFSR alone, further study is required to determine the impact of this approach on patient survival.

Sign in / Sign up

Export Citation Format

Share Document