Journal ArticleDOI
Intraoperative brain shift and deformation: a quantitative analysis of cortical displacement in 28 cases.
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TLDR
The data suggest that loss of spatial registration with preoperative images is gravity-dominated and of sufficient extent that attention to errors resulting from misregistration during the course of surgery is warranted.Abstract:
Objective A quantitative analysis of intraoperative cortical shift and deformation was performed to gain a better understanding of the nature and extent of this problem and the resultant loss of spatial accuracy in surgical procedures coregistered to preoperative imaging studies. Methods Three-dimensional feature tracking and two-dimensional image analysis of the cortical surface were used to quantify the observed motion. Data acquisition was facilitated by a ceiling-mounted robotic platform, which provided a number of precision tracking capabilities. The patient's head position and the size and orientation of the craniotomy were recorded at the start of surgery. Error analysis demonstrated that the surface displacement measuring methodology was accurate to 1 to 2 mm. Statistical tests were performed to examine correlations between the amount of displacement and the type of surgery, the nature of the cranial opening, the region of the brain involved, the duration of surgery, and the degree of invasiveness. Results The results showed that a displacement of an average of 1 cm occurred, with the dominant directional component being associated with gravity. The mean displacement was determined to be independent of the size and orientation of the cranial opening. Conclusion These data suggest that loss of spatial registration with preoperative images is gravity-dominated and of sufficient extent that attention to errors resulting from misregistration during the course of surgery is warranted.read more
Citations
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Journal ArticleDOI
Quantification of, visualization of, and compensation for brain shift using intraoperative magnetic resonance imaging.
Christopher Nimsky,Oliver Ganslandt,Simon Cerny,Peter Hastreiter,Günther Greiner,Rudolf Fahlbusch +5 more
TL;DR: In this paper, the authors used a 0.2-T open-configuration, magnetic resonance imaging scanner, located in an operating theater, for pre-and intra-operative imaging.
Journal ArticleDOI
Usefulness of intraoperative electrical subcortical mapping during surgery for low-grade gliomas located within eloquent brain regions: functional results in a consecutive series of 103 patients.
Hugues Duffau,Laurent Capelle,Dominique Denvil,Nicole Sichez,Peggy Gatignol,Luc Taillandier,Manuel Lopes,Mary-Christine Mitchell,Sabine Roche,Jean-Charles Muller,Ahmad Bitar,Jean-Pierre Sichez,Rémy van Effenterre +12 more
TL;DR: The authors used intraoperative real-time cortical and subcortical stimulations as a valuable adjunct to the other mapping methods to optimize the benefit/risk ratio of surgery of low-grade glioma invading eloquent regions.
Journal ArticleDOI
Serial intraoperative magnetic resonance imaging of brain shift.
Arya Nabavi,Peter McL. Black,David T. Gering,Carl-Fredrik Westin,Vivek Mehta,Richard S. Pergolizzi,Mathieu Ferrant,Simon K. Warfield,Nobuhiko Hata,Richard B. Schwartz,William M. Wells,Ron Kikinis,Ferenc A. Jolesz +12 more
TL;DR: Only serial intraoperative magnetic resonance imaging provides an accurate basis for the computational analysis of brain deformations, which might lead to an understanding and eventual simulation of brain shift for intraoperative guidance.
Journal ArticleDOI
Image-guidance for surgical procedures
TL;DR: Although image-guided surgery is now in extensive routine clinical use in neurosurgery and is gaining ground in other surgical disciplines, there remain many drawbacks that must be overcome before it can be employed in more general minimally-invasive procedures.
Journal ArticleDOI
Intraoperative ultrasound for guidance and tissue shift correction in image-guided neurosurgery.
TL;DR: A surgical guidance system that incorporates pre-operative image information with intraoperative ultrasound (US) imaging to detect and correct for brain tissue deformation during image-guided neurosurgery (IGNS) is presented.
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