Intraoperative magnetic resonance imaging to update interactive navigation in neurosurgery: Method and preliminary experience

Wirtz, Christian Rainer; Bonsanto, Mario M.; Knauth, Michael; Tronnier, V.; Albert, Fritz; Staubert, Andreas; Kunze, Stefan

doi:10.1002/(sici)1097-0150(1997)2:3/4<172::aid-igs4>3.0.co;2-t

Cited by 63 publications

(25 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6,9) Intraoperative CT and MR imaging are easily integrated into navigation systems and provide excellent images of anatomical deformation in the brain. 5,15,26) However, these imaging techniques are limited by factors such as manpower, cost, and restricted surgical access. 2,7,24) US scanners have been used for intraoperative imaging for 20 years.…”

Section: Discussion I Problems Of Conventional Navigation Systemsmentioning

confidence: 99%

“…Use of US requires only a few minutes, whereas CT and MR imaging require transportation of patients in and out of a sterile-draped imaging gantry, usually requiring about 30-70 minutes. 26) In addition, US can be repeated on demand. Another advantage is information about the extent of tumor removal.…”

Section: Discussion I Problems Of Conventional Navigation Systemsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Ohue

Kumon

Nagato

et al. 2010

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Image-guided neurosurgery using navigation systems is an essential tool to increase accuracy in brain tumor surgery. However, brain shift during surgery has remained problematic. The present study evaluated the utility of a new ultrasound (US)-linked navigation system for brain tumor surgery in 64 patients with intracranial tumors. The navigation system consisted of a StealthStation TM navigation system, a SonoNav TM system, and a standard US scanner. This system determines the orientation of the US images and reformats the images from preoperative computed tomography (CT) or magnetic resonance (MR) imaging to match the US images. The system was used intraoperatively to measure brain shift several times, using the results to guide tumor resection. US-linked navigation provided information regarding brain shift, and extent of tumor resection during surgery. Evaluation of brain shift was easily achieved in all patients, without using intraoperative CT or MR imaging. Accurate information regarding the true anatomical configuration of the patient could be obtained in all phases of the operation. Magnitude of brain shift increased progressively from pre-to post-resection and depended on the type of cranial structure. Integration of the US scanner with the navigation system allowed comparisons between the intraoperative US and preoperative images, thus improving interpretation of US images. The system also improved the rate of tumor resection by facilitating the detection of remnant tumor tissue. This US-linked navigation system provides information on brain shift, and improves the accuracy and utility of image-guided surgery.

show abstract

Section: Discussion I Problems Of Conventional Navigation Systemsmentioning

confidence: 99%

Section: Discussion I Problems Of Conventional Navigation Systemsmentioning

confidence: 99%

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Ohue

Kumon

Nagato

et al. 2010

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…20 Since 2009, a 1.5-T magnet has been used for intraoperative scans (Siemens Espree). The frequency of intraoperative scans is kept at a minimum (i.e., one per procedure) for reasons of time efficiency and accurate tissue contrast.…”

Section: Methods Prospective Imri Registrymentioning

confidence: 99%

Factors triggering an additional resection and determining residual tumor volume on intraoperative MRI: analysis from a prospective single-center registry of supratentorial gliomas

Scherer¹,

Jungk²,

Younsi³

et al. 2016

FOC

View full text Add to dashboard Cite

OBJECTIVE In this analysis, the authors sought to identify variables triggering an additional resection (AR) and determining residual intraoperative tumor volume in 1.5-T intraoperative MRI (iMRI)-guided glioma resections. METHODS A consecutive case series of 224 supratentorial glioma resections (WHO Grades I–IV) from a prospective iMRI registry (inclusion dates January 2011–April 2013) was examined with univariate and multiple regression models including volumetric data, tumor-related, and surgeon-related factors. The surgeon's expectation of an AR, in response to a questionnaire completed prior to iMRI, was evaluated using contingency analysis. A machine-learning prediction model was applied to consider if anticipation of intraoperative findings permits preoperative identification of ideal iMRI cases. RESULTS An AR was performed in 70% of cases after iMRI, but did not translate into an accumulated risk for neurological morbidity after surgery (p = 0.77 for deficits in cases with AR vs no AR). New severe persistent deficits occurred in 6.7% of patients. Initial tumor volume determined frequency of ARs and was independently correlated with larger tumor remnants delineated on iMRI (p < 0.0001). Larger iMRI volume was further associated with eloquent location (p = 0.010) and recurrent tumors (p < 0.0001), and with WHO grade (p = 0.0113). Greater surgical experience had no significant influence on the course of surgery. The surgeon's capability of ruling out an AR prior to iMRI turned out to incorporate guesswork (negative predictive value 43.6%). In a prediction model, AR could only be anticipated with 65% accuracy after integration of confounding variables. CONCLUSIONS Routine use of iMRI in glioma surgery is a safe and reliable method for resection guidance and is characterized by frequent ARs after scanning. Tumor-related factors were identified that influenced the course of surgery and intraoperative decision-making, and iMRI had a common value for surgeons of all experience levels. Commonly, the subjective intraoperative impression of the extent of resection had to be revised after iMRI review, which underscores the manifold potential of iMRI guidance. In combination with the failure to identify ideal iMRI cases preoperatively, this study supports a generous, tumor-oriented rather than surgeon-oriented indication for iMRI in glioma surgery.

show abstract

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18] Among these, CT and sonography are not extensively applied on direct intraoperative imaging because of their low image resolution of soft tissue. Although intraoperative MR imaging [12][13][14][15][16][17][18] provides the best solution for brain deformation, it is not widely applied due to its high cost and long image-updating time.…”

mentioning

confidence: 99%

A Sparse Intraoperative Data-Driven Biomechanical Model to Compensate for Brain Shift during Neuronavigation

Zhuang¹,

Liu²,

Wu³

et al. 2010

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Intraoperative magnetic resonance imaging to update interactive navigation in neurosurgery: Method and preliminary experience

Cited by 63 publications

References 21 publications

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Factors triggering an additional resection and determining residual tumor volume on intraoperative MRI: analysis from a prospective single-center registry of supratentorial gliomas

A Sparse Intraoperative Data-Driven Biomechanical Model to Compensate for Brain Shift during Neuronavigation

Contact Info

Product

Resources

About