Image Fusion for Skull Base Neuronavigation. Technical Note.

Sure, Ulrich; Benes, Ludwig; Riegel, Thomas; Schulte, Dirk Michael; Bertalanffy, Helmut

doi:10.2176/nmc.42.458

Cited by 22 publications

(14 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since the arteriovenous fistulas may be located within and around the hypoglossal canal as in patient 4 of our series, the rootlets of the nerve may be injured by surgical manipulation, even in the hands of a very experienced neurosurgeon. Preoperative imaging with thin-slice CT scans or image fusion technique (which was applied in the last three patients) [35] can provide valuable information about the local topographical anatomy. This information comprises the variable anatomical configuration of the jugular tubercle, the course of the canal containing the posterior condylar emissary vein, and the size and exact location of arteriovenous fistulas.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

et al. 2006

View full text Add to dashboard Cite

Dural arteriovenous fistulas located in the vicinity of the jugular foramen are complex vascular malformations and belong to the most challenging skull base lesions to treat. The authors comprehensively analyze multiple features in a series of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb. Four patients who underwent surgery via the transcondylar approach to treat dural arteriovenous fistulas around the jugular foramen were retrospectively reviewed. Previously, endovascular treatment was attempted in all patients. The success of the surgical treatment was examined with postoperative angiography. Complete obliteration of the dural arteriovenous fistulas (DAVFs) was achieved in three patients, and significant flow reduction in one individual. All patients had a good postoperative outcome, and only one experienced mild hypoglossal nerve palsy. Despite extensive bone drilling, an occipitocervical fusion was necessary in only one patient with bilateral lesions. The use of an individually tailored transcondylar approach to treat dural arteriovenous fistulas at the region of the jugular foramen is most effective. This approach allows for complete obliteration of the connecting arterial feeders, and removal of bony structures containing pathological vessels.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

et al. 2006

View full text Add to dashboard Cite

show abstract

“…The automatic image fusion module computes all rigid transformations from one image set into another such that the image sets match [17]. Central parts of the brain such as choroid plexus calcifications and lateral ventricles were taken as anatomical reference points to check image fusion and to fine-tune it if necessary (fig.…”

Section: Methodsmentioning

confidence: 99%

Treatment of Chronic Pain: Diffusion Tensor Imaging Identification of the Ventroposterolateral Nucleus Confirmed with Successful Deep Brain Stimulation

Kovanlıkaya¹,

Heier²,

Kaplitt

2014

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background/Aims: A variety of pain syndromes have been treated successfully with deep brain stimulation (DBS) by targeting the thalamic ventroposterolateral (VPL) nucleus. The purpose of this study was to preoperatively identify the thalamic VPL nucleus by diffusion tensor imaging (DTI) fiber tractography (FT) and confirm it intraoperatively. Methods and Results: FT was performed to identify the thalamic VPL nucleus in 6 healthy volunteers and a patient with intractable chronic pain. The patient had preoperative DTI followed by DBS with the electrode placed by conventional stereotactic methods. Postoperative CT images of the DBS electrode tip were fused with the preoperative DTI and the electrode was noted to be in the position of the VPL nucleus predicted preoperatively by FT. The electrode was then used as a seed region of interest (ROI) to confirm FT back to the somatosensory cortex. Clinical confirmation was also achieved with the patient's pain relief. In all volunteers, VPL nuclei were identified in similar locations in both thalami, although slight inter- and intrasubject differences were observed. Conclusion: DTI has the potential to identify the thalamic nuclei in individuals, which would be more accurate than anatomical localization and likely identical to intraoperative physiological testing. Postoperative DBS electrode placement and the affected cortical areas can be confirmed with coregistration of CT and FT using the electrode as a seed ROI.

show abstract

“…As an option, CT and MRI scans are fused so that both imaging modalities can be used during surgery. This technique was described previously in detail (30). The preplanned patient data are now transferred from the planning computer to the navigation station via zip disk or intranet.…”

Section: Data Preparationmentioning

confidence: 99%

“…In some instances, these modern imaging tools have proved to be considerably useful in terms of reduced operative time and refined neurosurgical procedures (6,11,24,30,31). However, the conventional neuronavigation systems still have practical limitations because of lack of the intraoperative imaging that provides information on dynamic changes that occur during surgery.…”

Section: Intraoperative Image-guided Modalities: General Considerationsmentioning

confidence: 99%

“…The combined use of ultrasound together with a navigation system provides an alternative instrument that is convenient to use and leads to a less time-consuming procedure with reasonable prizes (5,10,19,30,36,39,40). During the surgical resection of vascular malformations, intraoperative physiological parameters (such as amount of blood flow and its direction) can be detected.…”

Section: Intraoperative Ultrasoundmentioning

confidence: 99%

See 1 more Smart Citation

A Novel Platform for Image-guided Ultrasound

et al. 2006

Self Cite

View full text Add to dashboard Cite

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 oneplatform 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.

show abstract

Image Fusion for Skull Base Neuronavigation. Technical Note.

Cited by 22 publications

References 7 publications

Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

Treatment of Chronic Pain: Diffusion Tensor Imaging Identification of the Ventroposterolateral Nucleus Confirmed with Successful Deep Brain Stimulation

A Novel Platform for Image-guided Ultrasound

Contact Info

Product

Resources

About