Intraoperative Imaging Modalities and Compensation for Brain Shift in Tumor Resection Surgery

Abstract

Intraoperative brain shift during neurosurgical procedures is a well-known phenomenon caused by gravity, tissue manipulation, tumor size, loss of cerebrospinal fluid (CSF), and use of medication. For the use of image-guided systems, this phenomenon greatly affects the accuracy of the guidance. During the last several decades, researchers have investigated how to overcome this problem. The purpose of this paper is to present a review of publications concerning different aspects of intraoperative brain shift especially in a tumor resection surgery such as intraoperative imaging systems, quantification, measurement, modeling, and registration techniques. Clinical experience of using intraoperative imaging modalities, details about registration, and modeling methods in connection with brain shift in tumor resection surgery are the focuses of this review. In total, 126 papers regarding this topic are analyzed in a comprehensive summary and are categorized according to fourteen criteria. The result of the categorization is presented in an interactive web tool. The consequences from the categorization and trends in the future are discussed at the end of this work.

Effects of surgical targeting in laser interstitial thermal therapy for mesial temporal lobe epilepsy: A multicenter study of 234 patients

“…32,33 The 1.3% rate of radiographic hemorrhage, 0.4% rate of symptomatic hemorrhage, and 0.4% rate of permanent deficit from hemorrhage is comparable to reported rates in stereotactic neurosurgical procedures. 10,29,36,37 Visual complications in 5.1% of this cohort are lower than what has been reported for both LITT and temporal lobe resections. Comorbid mood disturbances in patients with epilepsy with worsening of symptoms after temporal lobe surgery have been described.…”

“…Visual disturbances such as diplopia and visual field loss have also been commonly described complications of temporal lobe surgery. 10,29,36,37 Visual complications in 5.1% of this cohort are lower than what has been reported for both LITT and temporal lobe resections. Of interest, the presence of a postoperative complication was associated with poorer seizure outcome.…”

“…Studies have emphasized the need for sufficient hippocampal resection to maximize chances of seizure freedom. 29 As such, measurements on postoperative images remain challenging for procedures like a temporal lobectomy. [26][27][28] Prior studies of LITT for mTLE have demonstrated no relationship between the ablation volumes and seizure outcomes.…”

“…After a craniotomy, tissue manipulation, removal of brain tissue, loss of cerebrospinal fluid, gravity, and use of osmotic therapy distort patient anatomy on postoperative imaging. 29 As such, measurements on postoperative images remain challenging for procedures like a temporal lobectomy. The minimally invasive nature of LITT, however, results in minimal anatomic distortion and affords more accurate quantification of the intervention.…”

Computational Biomechanics of the Brain in the Operating Theatre

“…This enables to visualize inner structures, surgical targets or planning at key moments of the surgery where assistance is needed. Many image-to-image registration algorithms were proposed in the literature [1,7]. In this paper, we will only focus on biomechanical model-based solutions.…”