Real-Time Atlas-Based Stereotactic Neuronavigation

Abstract

DAT, deformable anatomic templateDES, direct electrical stimulationDTI, diffusion tensor imagingfMRI, functional magnetic resonance imaging.

High-resolution imaging of the central nervous system

“…Lesions located immediately adjacent to the motor and sensory areas of the EC are of particular interest, as they carry a high risk of postoperative neurological deficits in the patient due to inadvertent injury and infiltration of the tumor tissue into the motor/sensory cortex and long tracts . Although the optimal surgical case would result in minimal neurological damage as a result of resection, increasing evidence suggests that the extensive resection of a brain tumor increases the delay in tumor progression, reduces recurrence, and improves patient quality of life and life expectancy (Vabulas et al, 2014). With this knowledge, surgeons must constantly evaluate and compare the benefits of maximal resection with the risks of permanent neurological deficit and its associated sociological and financial implications (Kumar et al, 2013).…”

“…Recently, the concept of real-time atlasbased stereotactic neuronavigation has been researched to integrate brain atlases with IGS systems to improve postoperative outcomes (Vabulas et al, 2014). There are limitations to IGS neuronavigation as well as the routine imaging process prior to surgery, such as difficulties in localizing white matter tracts in tumor masses (Vabulas et al, 2014).…”

“…However, this challenge can be overcome with the integration of deformable anatomic template (DAT) atlases with patient scans. The combination of these methods enables extensive visualization of functional information both in and around the brain tumors (Vabulas et al, 2014;Fig. 5).…”

“…Previous research has demonstrated that direct electrical stimulation (DES) closely matches with DTI and DAT maps, while providing locations of anatomical structures within a 5-mm margin of error (Vabulas et al, 2014). Although DES mapping continues to be the gold standard for identifying cortical and subcortical areas of interest, it can occasionally fail (Vabulas et al, 2014).…”

Diagnostic and Therapeutic Uses of Nanomaterials in the Brain

“…The stereotactic operation has been commonly employed in the field of neurosurgery to perform injections, implantations, stimulation and biopsies [57,58]. Traditionally, frame-based techniques were the standard method used and more recently, frameless stereotaxy or neuronavigation has been introduced [59,60]. One relevant aspect of stereotactic surgery is that drugs can be easily administered in precise, discreet and functional areas in the brain, without causing any damage in the surrounding tissue.…”