Navigation system based on intraoperative diffusion weighted imaging using open MRI

Ozawa, N.; Muragakı, Yoshihiro; Shirakawa, Hiroshi; Suzukawa, Henry H.; Nakamura, Ryoichi; Iseki, Hiroshi

doi:10.1016/j.ics.2005.03.138

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…9 Using a 0.3-tesla open-MRI scanner to obtain a DW image for navigation, the authors conˆrmed small distortion of the pyramidal tract location using electrophysiological monitoring of motor evoked potential. 8 Gasser's group identiˆed functional areas by performing intraoperative functional MRI (1.5 tesla) by median nerve stimulation rather than identifying function using awake surgery. 21 Some investigators identiˆed functional areas using intraoperative functional MR images acquired by low magneticˆeld (0.12 tesla), mobiletype open-MRI scanner (PoleStar TM N-10, Odin Medical Technologies).…”

Section: Discussionmentioning

confidence: 99%

“…A report at the Computer Assisted Radiology and Surgery International Congress and Exhibition in Berlin in 2005 indicated that damage from image distortion could be alleviated by using a wide margin around the pyramidal tract on the tractogram acquired by MRI with high magnetiĉ eld strength for navigation. 8 Visualization of the pyramidal tract on a 3-dimensional DW image with low distortion and use of the image to update navigation to compensate for the brain shift enabled the surgeon to perform radical resection of malignant tumor near the pyramidal tract ( Fig. 4).…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

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Intelligent Operating Theater Using Intraoperative Open-MRI

et al. 2005

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Malignant brain tumors vary among patients and are characterized by their irregular shapes and infiltration. Localization of functional areas in the brain also differs among patients, and excess removal of tumor near eloquent areas may increase the risk of damage of function, such as motor paresis and speech disturbance. Recent progress in magnetic resonance (MR) imaging technology has enabled acquisition of intraoperative images and totally changed the neurosurgery of malignant brain tumors. Before, surgeons could merely speculate about the results of surgical manipulation and have no certainty about procedure outcomes until postoperative examination. Because intraoperative MR images allow visualization of the size of residual tumor(s) and the positional relationship between the tumor(s) and eloquent areas, surgeons are now able to achieve safe and reliable surgery. As an example, positional error on preoperative MR images caused by shifting of the brain (brain shift), a long-standing annoyance for surgeons, has been resolved using intraoperative MR images for surgical navigation, allowing precise resection. Two types of open-MR imaging scanner, a 0.2- or 0.3-tesla hamburger-type scanner with a horizontal gap and a 0.12- or 0.5-tesla double doughnut-type scanner with a vertical gap, are now available in the operating theater, and 1.5-tesla bore-type scanners are available. A 3.0-tesla bore-type scanner is planned. Intraoperative MR imaging includes diffusion-tensor and diffusion-weighted imaging, which allows visualization of nerve fibers in the white matter, especially the pyramidal tract. Such images are valuable aids in the precise resection of residual lesions of malignant brain tumors near eloquent areas without injuring motor function.

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Section: Discussionmentioning

confidence: 99%

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

Intelligent Operating Theater Using Intraoperative Open-MRI

et al. 2005

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“…The fi rst one can provide only functional information and does not permit precise estimation of the exact course of the pyramidal tract, whereas the second is susceptible to mislocalization errors, particularly those caused by brain shift [11,12] . The technique of intraoperative DWI (iDWI) using an intraoperative MR scanner of low magnetic fi eld strength (0.3 Tesla), has been developed recently in Tokyo Women ' s Medical University [13,14] . After validation of Precise identifi cation and preservation of the pyramidal tract during surgery for parenchymal brain tumors is of crucial importance for the avoidance of postoperative deterioration of the motor function.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Diffusion-Weighted Imaging for Visualization of the Pyramidal Tracts. Part II: Clinical Study of Usefulness and Efficacy

Ozawa

Muragakı

Nakamura

et al. 2008

Minim Invasive Neurosurg

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Precise identification and preservation of the pyramidal tract during surgery for parenchymal brain tumors is of crucial importance for the avoidance of postoperative deterioration of the motor function. The technique of intraoperative diffusion-weighted imaging (iDWI) using an intraoperative MR scanner of low magnetic field strength (0.3 Tesla) has been developed. Its clinical usefulness and efficacy were evaluated in 10 surgically treated patients with gliomas (5 men and 5 women, mean age: 41.2+/-13.9 years). iDWI permitted visualization of the pyramidal tract on the non-affected side in all 10 cases, and on the affected side in 8 cases. Motion artifacts were observed in four patients, but were not an obstacle to identification of the pyramidal tract. Good correspondence of the anatomical landmarks localization on iDWI and T (1)-weighted imaging was found. All participating neurosurgeons agreed that, in the majority of cases, iDWI was very useful for localization of the pyramidal tract and for clarification of its spatial relationships with the tumor. In conclusion, image quality and accuracy of the iDWI obtained with an MR scanner of low magnetic field strength (0.3 Tesla) are sufficient for possible incorporation into an intraoperative neuronavigation system. The use of iDWI in addition to structural iMRl and subcortical functional mapping with electrical stimulation can potentially result in a reduction of the postoperative morbidity after aggressive surgical removal of lesions located in the vicinity to the motor white matter tracts.

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Navigation system based on intraoperative diffusion weighted imaging using open MRI

Cited by 2 publications

References 26 publications

Intelligent Operating Theater Using Intraoperative Open-MRI

Intelligent Operating Theater Using Intraoperative Open-MRI

Intraoperative Diffusion-Weighted Imaging for Visualization of the Pyramidal Tracts. Part II: Clinical Study of Usefulness and Efficacy

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