Functional neuronavigation combined with intra-operative 3D ultrasound: Initial experiences during surgical resections close to eloquent brain areas and future directions in automatic brain shift compensation of preoperative data

Rasmussen, Inge-André; Lindseth, Frank; Rygh, Ola M.; Berntsen, Erik Magnus; Selbekk, Tormod; Xu, Jian; Hernes, Toril A. Nagelhus; Harg, Erik; Håberg, Asta; Unsgaard, Geirmund

doi:10.1007/s00701-006-1110-0

Cited by 147 publications

(79 citation statements)

References 37 publications

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“…5,18 Furthermore, intraoperative ultrasonography has been shown to successfully integrate with functional MRI and DTI to provide an intraoperative update to neuronavigation accounting for brain shift. 26 While we found iMRI to be a powerful addition to preexisting epilepsy protocol techniques, its resolution is limited to approximately 1 mm. 17 In eloquent cortex resections where lesions less than 5 mm from functional tissue are associated with increased risk of neurological deficit, iMRI resolution may potentially be limited.…”

Section: Discussionmentioning

confidence: 92%

The role of intraoperative MRI in resective epilepsy surgery for peri-eloquent cortex cortical dysplasias and heterotopias in pediatric patients

Sacino¹,

Murnick

et al. 2016

FOC

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OBJECTIVE Previous studies have demonstrated that an important factor in seizure freedom following surgery for lesional epilepsy in the peri-eloquent cortex is completeness of resection. However, aggressive resection of epileptic tissue localized to this region must be balanced with the competing objective of retaining postoperative neurological functioning. The objective of this study was to investigate the role of intraoperative MRI (iMRI) as a complement to existing epilepsy protocol techniques and to compare rates of seizure freedom and neurological deficit in pediatric patients undergoing resection of perieloquent lesions. METHODS The authors retrospectively reviewed the medical records of pediatric patients who underwent resection of focal cortical dysplasia (FCD) or heterotopia localized to eloquent cortex regions at the Children's National Health System between March 2005 and August 2015. Patients were grouped into two categories depending on whether they underwent conventional resection (n = 18) or iMRI-assisted resection (n = 11). Patient records were reviewed for factors including demographics, length of hospitalization, postoperative seizure freedom, postoperative neurological deficit, and need for reoperation. Postsurgical seizure outcome was assessed at the last postoperative follow-up evaluation using the Engel Epilepsy Surgery Outcome Scale. RESULTS At the time of the last postoperative follow-up examination, 9 (82%) of the 11 patients in the iMRI resection group were seizure free (Engel Class I), compared with 7 (39%) of the 18 patients in the control resection group (p = 0.05). Ten (91%) of the 11 patients in the iMRI cohort achieved gross-total resection (GTR), compared with 8 (44%) of 18 patients in the conventional resection cohort (p = 0.02). One patient in the iMRI-assisted resection group underwent successful reoperation at a later date for residual dysplasia, compared with 7 patients in the conventional resection cohort (with 2/7 achieving complete resection). Four (36%) of the patients in the iMRI cohort developed postoperative neurological deficits, compared with 15 patients (83%) in the conventional resection cohort (p = 0.02). CONCLUSIONS These results suggest that in comparison with a conventional surgical protocol and technique for resection of epileptic lesions in peri-eloquent cortex, the incorporation of iMRI led to elevated rates of GTR and postoperative seizure freedom. Furthermore, this study suggests that iMRI-assisted surgeries are associated with a reduction in neurological deficits due to intraoperative damage of eloquent cortex.

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Section: Discussionmentioning

confidence: 92%

The role of intraoperative MRI in resective epilepsy surgery for peri-eloquent cortex cortical dysplasias and heterotopias in pediatric patients

Sacino¹,

Murnick

et al. 2016

FOC

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“…The ultrasound based neuronavigation is interesting and cost a lot less than iCT or iMRI. Combination of these neuroimages with awake brain mapping surgery is regarded by most as a gold standard for brain tumor surgery which lies near the eloquent area of the cortex [17][18][19][20][21][22][23]. …”

Section: Intra-and Extraoperative Neuroimages and Neuronavigationmentioning

confidence: 99%

“…Neuronal property of creating oscillation inside our brain is important for normal brain functioning. Neural oscillation contributes to neural coding, brain rhythms with different types or frequency of oscillatory activity [5 type of brain waves: gamma (above 30 Hz), beta [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], alpha (8)(9)(10)(11)(12)(13), theta [4][5][6][7][8] and delta [0.5 -4 Hz); sleep spindles; Mu waves; thalamocortical oscillations; epileptic seizures and bursting] and fast information processing and transfer. Interestingly, neural oscillations also play an important role in many neurological disorders such as excessive synchronisation during seizure in epilepsy or tremors in movement disorders [69].…”

Section: New Concept -Brain Waves Oscillations and Networkmentioning

confidence: 99%

Functional MRI, Diffusion Tensor Imaging, Magnetic Source Imaging and Intraoperative Neuromonitoring Guided Brain Tumor Resection in Awake and Under General Anaesthesia

Idris¹,

Hassan²,

Mustapha³

et al. 2013

Clinical Management and Evolving Novel Therapeutic Strategies for Patients With Brain Tumors

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“…The data of fMRI and DTI can be integrated into 3D-ultrasound in order to correct the deviation caused by brain shift (Rasmussen et al, 2007).…”

Section: The Combined Application Of Fmri and 3d-ultrasoundmentioning

confidence: 99%

Imaging Techniques in Brain Tumor

Yu¹,

Ye²,

Qi³

et al. 2011

Diagnostic Techniques and Surgical Management of Brain Tumors

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Functional neuronavigation combined with intra-operative 3D ultrasound: Initial experiences during surgical resections close to eloquent brain areas and future directions in automatic brain shift compensation of preoperative data

Cited by 147 publications

References 37 publications

The role of intraoperative MRI in resective epilepsy surgery for peri-eloquent cortex cortical dysplasias and heterotopias in pediatric patients

The role of intraoperative MRI in resective epilepsy surgery for peri-eloquent cortex cortical dysplasias and heterotopias in pediatric patients

Functional MRI, Diffusion Tensor Imaging, Magnetic Source Imaging and Intraoperative Neuromonitoring Guided Brain Tumor Resection in Awake and Under General Anaesthesia

Imaging Techniques in Brain Tumor

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