Equipment configuration and procedures: Preferences for interventional micro therapy

Grönemeyer, Dietrich; Seibel, Rainer; Erbel, Raimund; Schmidt, A; Melzer, Andreas; Plassmann, J.; Deli, M.; Schmermund, Axel; Baumgart, Dietrich; Welsch, Roy E.; Ge, Jiajia; Goerge, G.

doi:10.1007/bf03168861

Cited by 21 publications

(14 citation statements)

References 10 publications

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“…Early interventional procedures in an open MRI system were performed in a low-field imager by Gronemeyer and colleagues 19,20. This system provided access to patients through a horizontal gap in its magnet.…”

Section: Origins Of Intraoperative Mri: 05t Open-configuration Protomentioning

confidence: 99%

Origins of Intraoperative MRI

Mislow

Golby

Black

2009

Neurosurgery Clinics of North America

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Successful neurosurgical procedures hinge on the accurate targeting of regions of interest. Resection of brain tumors is enhanced by the surgeon's ability to accurately define margins. Epileptic foci are identified by coregistration of functional and antatomic information, and stereotactic targets must be pinpointed with submillimetric accuracy for surgical efficacy. Specialized neuronavigational tools have been developed over the last 20 years to assist surgeons in these endeavors; the development of MRI-guided navigation systems represents a significant improvement in the surgical treatment of various intracranial lesions. The ability for most intraoperative image guidance systems to remain faithful to the anatomy once the cranium has been opened remains problematic, however. "Brain shift," the term applied to the dynamic change that intracranial anatomy undergoes after craniotomy, burr hole placement, drainage of cerebrospinal fluid, or resection of a lesion, compromises the localization of neural structures in space relative to where they were when preoperative images were acquired (Fig. 1).1-8 Gliomas also pose a particular challenge to surgeons because many of these tumors (particularly low-grade gliomas) do not possess distinct capsules. As a result, even well-trained human eyes are incapable of discerning where the border of the lesion ends and viable brain begins. This uncertainty leads to two problems: (1) inadequate resection secondary to the surgeon stopping at what appears to be grossly abnormal tissue (so as to avoid neurologic damage) and (2) neurologic damage caused by aggressive surgery in which resection ends only when clearly normal brain tissue is visualized.Only intraoperatively acquired images can provide neurosurgeons with the information needed to perform real-time, image-guided surgery. Uncertainty is reduced significantly when the surgeon places an instrument at the edge of what is believed to be the resection cavity, and a small nodule of tumor is immediately identified by intraoperative imaging. Avoidance and preservation of eloquent cortex such as motor, speech, and visual areas depend on precise identification of these regions during the procedure. The boundary between tumor and viable neural tissue is often difficult to see with the naked eye, so the superimposition of functional MRI, diffusion tensor imaging, and awake cortical mapping images eliminates a surgeon's uncertainty in determining tumor boundary and shifting brain * Corresponding author. agolby@partners.org (A.J. Golby). Early interventional procedures in an open MRI system were performed in a low-field imager by Gronemeyer and colleagues.19,20 This system provided access to patients through a horizontal gap in its magnet. Access was significantly limited, however, and open surgeries that required full access to patients were impractical. Based on this information, after discussing several alternative designs, a "double donut" magnet system that would allow free access to patients within the magnetic field was chosen by...

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Section: Origins Of Intraoperative Mri: 05t Open-configuration Protomentioning

confidence: 99%

Origins of Intraoperative MRI

Mislow

Golby

Black

2009

Neurosurgery Clinics of North America

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“…Toutefois, la masse de métal est bien supérieure dans le cas du boîtier du coeur artificiel total implantable. Le développe-ment débridé de la chirurgie avec effraction tissulaire minimale devra faire appel aux matériaux compatibles avec l'IRM : le titane et ses alliages apparaissent très séduisants pour la fabrication de stents dont la masse ne dépasse pas quelques grammes [83,84]. La mise en place et le suivi au long cours de prothèses ayant des masses supérieures (hanche, coeur artificiel) doivent être validés avant toute générali-sation.…”

Section: Sélection De L'alliage Ti6al4v Pour La Fabrication Du Boîtieunclassified

Sélection des matériaux pour la conception et le développement du boîtier d'un cœur artificiel total implantable : supériorité du titane et de ses alliages

Guidoin

2004

ITBM-RBM

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“…1,4,7,13 Specially developed shielding of the electronic equipment allows the increasing use of lasers, endoscopic systems, monitors, light boxes, etc., near MRI systems. Because the image on flat light emitting diode monitors is not sensitive to magnetic distortion, they can be used for displaying MRI scans in the operating room and for endoscopy, ultrasound, or other types of imaging.…”

Section: Electronic Equipment Software and Instrumentsmentioning

confidence: 99%

“…1 In the field of minimally invasive therapy, this guarantees safe and transparent access into the body, especially in highrisk areas such as the spine and brain.…”

Section: Introductionmentioning

confidence: 99%

Tomographic microtherapy

Gr�nemeyer¹,

Gevargez²,

Seibel³

et al. 1998

Comput. Aided Surg.

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Minimally invasive techniques using endoscopes for image-guided therapy are now common in the field of surgery. Fast real-time radiologic imaging should be integrated into the procedure for increased safety in access and guidance techniques for endoscopes and instruments. The transparency of computed tomography (CT) guidance, magnetic resonance imaging, and electron beam tomography scan techniques allows precise guidance of instruments and endoscopes while permitting their diameter to be minimized. This guarantees safe and transparent access into the body, especially in high-risk areas such as the spine and brain. Combining both technologies has the potential to reduce complications and offers significant advantages in microinvasive operative procedures such as biopsies; local tumor therapy with lasers, radio frequency, or drugs; and percutaneous diskectomies or implants. CT is the golden standard for microtherapeutic procedures because of its precise tip discrimination.

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Equipment configuration and procedures: Preferences for interventional micro therapy

Cited by 21 publications

References 10 publications

Origins of Intraoperative MRI

Origins of Intraoperative MRI

Sélection des matériaux pour la conception et le développement du boîtier d'un cœur artificiel total implantable : supériorité du titane et de ses alliages

Tomographic microtherapy

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