Frameless Stereotactic Biopsy with DTI-Based Tractography Integration: How to Adjust the Trajectory—A Case Series

Bertuccio, Alessandro; Elia, Angela Rita; Robba, Chiara; Scaglione, Giorgio; Longo, Gian Paolo; Sgubin, Donatella; Vitali, Matteo; Barbanera, Andrea

doi:10.1016/j.wneu.2020.08.041

Cited by 4 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the best of our knowledge, this study is the largest series (190 trajectories) analysing the role of tractography in nBx for central core METs [ 4 , 13 ] in a simulation setting. Information provided by the tractography does influence biopsy planning of the METs resulting in shorter planning time, fewer trajectory/ lobe changes and safer trajectories.…”

Section: Discussionmentioning

confidence: 99%

“…With the anatomy guided biopsies, there is a higher risk of transgressing the CST unknowingly due to the unpredictable interaction between the tumour and the CST. There are only 2 studies in the literature which directly compare the influence of tractography in stereotactic biopsy [ 4 , 13 ]. Around 36–58% of surgeons modified their trajectory after superimposing the tracts on their anatomy-guided planning [ 4 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are only 2 studies in the literature which directly compare the influence of tractography in stereotactic biopsy [ 4 , 13 ]. Around 36–58% of surgeons modified their trajectory after superimposing the tracts on their anatomy-guided planning [ 4 , 13 ]. Hence the risk of transgressing CST is presumed to be higher when tractography is unavailable, thereby increasing the risk for neurological morbidity (shown in Figure 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pre-operative anatomical dissection of these tracts may help the surgeon in deciding the best trajectory. Few studies have analysed the influence of tractography on image guided biopsy [ 4 , 13 ]. Preliminary data from these studies suggest that tractography enhanced nBx may decrease morbidity by influencing a surgeon to modify the trajectory based on the interaction between white matter fibres and the tumour [ 4 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have analysed the influence of tractography on image guided biopsy [ 4 , 13 ]. Preliminary data from these studies suggest that tractography enhanced nBx may decrease morbidity by influencing a surgeon to modify the trajectory based on the interaction between white matter fibres and the tumour [ 4 , 13 ]. However, tractography has its own inherent issues, including different protocols to image the tracts (diffusion tensor model vs constrained spherical model [ 14 ]); and different tracking algorithms (deterministic vs probabilistic approach [ 12 , 15 ]).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study

Srinivasan

Lavrador

Tambirajoo

et al. 2023

JPM

View full text Add to dashboard Cite

Safe Trajectory planning for navigation guided biopsy (nBx) of motor eloquent tumours (METs) is important to minimise neurological morbidity. Preliminary clinical data suggest that visualisation of the corticospinal tract (CST) and its relation to the tumour may aid in planning a safe trajectory. In this article we assess the impact of tractography in nBx planning in a simulation-based exercise. This single centre cross-sectional study was performed in March 2021 including 10 patients with METs divided into 2 groups: (1) tractography enhanced group (T-nBx; n = 5; CST merged with volumetric MRI); (2) anatomy-based group (A-nBx; n = 5; volumetric MRI only). A biopsy target was chosen on each tumour. Volunteer neurosurgical trainees had to plan a suitable biopsy trajectory on a Stealth S8® workstation for all patients in a single session. A trajectory safety index (TSI) was devised for each trajectory. Data collection and analysis included a comparison of trajectory planning time, trajectory/lobe changes and TSI. A total of 190 trajectories were analysed based on participation from 19 trainees. Mean trajectory planning time for the entire cohort was 225.1 ± 21.97 s. T-nBx required shorter time for planning (p = 0.01). Mean trajectory changes and lobe changes made per biopsy were 3.28 ± 0.29 and 0.45 ± 0.08, respectively. T-nBx required fewer trajectory/lobe changes (p = 0.01). TSI was better in the presence of tractography than A-nBx (p = 0.04). Neurosurgical experience of trainees had no significant impact on the measured parameters despite adjusted analysis. Irrespective of the level of neurosurgical training, surgical planning of navigation guided biopsy for METs may be achieved in less time with a safer trajectory if tractography imaging is available.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study

Srinivasan

Lavrador

Tambirajoo

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

Frameless neuronavigation-assisted brain biopsy with electromagnetic tracking: how I do it?

et al. 2022

View full text Add to dashboard Cite

Robot-assisted endoscopic third ventriculostomy under intraoperative CT imaging guidance

et al. 2023

View full text Add to dashboard Cite

Background The robot-assisted neurosurgical procedures have recently benefited of the evolution of intraoperative imaging, including mobile CT unit available in the operating room. This facilitated use paved the way to perform more neurosurgical procedures under robotic assistance. Endoscopic third ventriculocisternostomy requires both a safe transcortical trajectory and a smooth manipulation. Method We describe our technique of robot-assisted endoscopic third ventriculocisternostomy combining robotic assistance and intraoperative CT imaging. Conclusion Robot-assisted endoscopic third ventriculocisternostomy using modern intraoperative neuroimaging can be easily implemented and prevented erroneous trajectory and abrupt endoscopic movements, reducing surgically induced brain damages.

show abstract

Frameless Stereotactic Biopsy with DTI-Based Tractography Integration: How to Adjust the Trajectory—A Case Series

Cited by 4 publications

References 23 publications

Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study

Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study

Frameless neuronavigation-assisted brain biopsy with electromagnetic tracking: how I do it?

Robot-assisted endoscopic third ventriculostomy under intraoperative CT imaging guidance

Contact Info

Product

Resources

About