Preliminary experience with an intraoperative MRI-compatible infant headholder: technical note

Boop, Frederick A.; Bate, Berkeley Graham; Choudhri, Asim F.; Burkholder, Brian; Klimo, Paul

doi:10.3171/2014.10.peds14447

Cited by 11 publications

(3 citation statements)

References 23 publications

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“…In very young patients, in whom a headrest along with the spike headrest was necessary to maintain stability, compatible MRI headrests were not used. These limitations have also been reported by other groups ( 31 , 45 ).…”

Section: Discussionsupporting

confidence: 77%

The impact of 1.5-T intraoperative magnetic resonance imaging in pediatric tumor surgery: Safety, utility, and challenges

et al. 2023

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ObjectiveIn this study, we present our experience with 1.5-T high-field intraoperative magnetic resonance imaging (ioMRI) for different neuro-oncological procedures in a pediatric population, and we discuss the safety, utility, and challenges of this intraoperative imaging technology.MethodsA pediatric consecutive-case series of neuro-oncological surgeries performed between February 2020 and May 2022 was analyzed from a prospective ioMRI registry. Patients were divided into four groups according to the surgical procedure: intracranial tumors (group 1), intraspinal tumors (group 2), stereotactic biopsy for unresectable tumors (group 3), and catheter placement for cystic tumors (group 4). The goal of surgery, the volume of residual tumor, preoperative and discharge neurological status, and postoperative complications related to ioMRI were evaluated.ResultsA total of 146 procedures with ioMRI were performed during this period. Of these, 62 were oncology surgeries: 45 in group 1, two in group 2, 10 in group 3, and five in group 4. The mean age of our patients was 8.91 years, with the youngest being 12 months. ioMRI identified residual tumors and prompted further resection in 14% of the cases. The mean time for intraoperative image processing was 54 ± 6 min. There were no intra- or postoperative security incidents related to the use of ioMRI. The reoperation rate in the early postoperative period was 0%.ConclusionioMRI in pediatric neuro-oncology surgery is a safe and reliable tool. Its routine use maximized the extent of tumor resection and did not result in increased neurological deficits or complications in our series. The main limitations included the need for strict safety protocols in a highly complex surgical environment as well as the inherent limitations on certain patient positions with available MR-compatible headrests.

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Section: Discussionsupporting

confidence: 77%

The impact of 1.5-T intraoperative magnetic resonance imaging in pediatric tumor surgery: Safety, utility, and challenges

et al. 2023

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“… 8 – 10 A new VISIUS Surgical Theatre features an MR scanner, a bi-plane angiography system and a neurosurgical operative room, where the MR scanner can be deployed into any of three rooms permitting rapid transitions between MR imaging, conventional surgery or endovascular intervention. 11 This also allows the MRI to be used for diagnostic purposes when not in use intraoperatively.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of intraoperative MRI for endovascular coiling of intracranial aneurysms: A single centre experience

et al. 2022

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Background Intraoperative magnetic resonance imaging system (iMRIS) surgical theatre is a highly integrated operating room with an intraoperative magnetic resonance imaging (iMRI) designed originally for brain tumour surgery. Its use in neurointerventional procedures, particularly in the setting of endovascular coiling of intracranial aneurysms, has not been discussed in the literature to date. We present our initial experience about the safety and feasibility of iMRI to assess post operative complications and provide baseline imaging post coiling of intracranial aneurysms. Methods Consecutive patients who underwent iMRI between 2015 and 2018 were included in the study. Demographic, clinical details, endovascular technique and surgical outcomes were collected. Details of anesthesia during the procedure were also collected. Results Fifteen patients underwent iMRI with MRA to assess post coiling status of their elective endovascular coiling of intracranial aneurysms. The mean age in this cohort was 61 years and 46.7% were male. No immediate complications were seen either from the endovascular procedures or from the iMRI. All iMRI scans were performed as planned with no aborted or truncated scans. The image quality of the iMRI/MRA was adequate to detect the residual aneurysm, if present. There was no residual aneurysm on the angiogram that were not detected on the iMRIs. Of the 15 patients, 10 were safely discharged the following day and other 5 were discharged 2 days after their surgery. Conclusions The iMRI is an advantageous tool which can be integrated into neurointerventional workflow resulting in early post peri-procedural feedback and potentially reduced post-operative hospital stay.

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“…Often in DBS surgery, co-registration is done automatically, based on the proprietary software of the surgical navigation system. For example, the StealthStation ® (Medtronic, Minneapolis, MN, USA) is a popular navigation system used in stereotactic and functional surgery [7][8][9][10][11][12]. This system automatically co-registers images using software such as FrameLink TM (Medtronic, Minneapolis, MN, USA), one of the most common DBS planning software programs for both surgical and clinical research applications for nearly 2 decades.…”

Section: Introductionmentioning

confidence: 99%

CT and MRI Image Fusion Error: An Analysis of Co-Registration Error Using Commercially Available Deep Brain Stimulation Surgical Planning Software

Burke

Tanzillo

Starr

et al. 2021

Stereotact Funct Neurosurg

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Introduction: During deep brain stimulation (DBS) surgery, computed tomography (CT) and magnetic resonance imaging (MRI) scans need to be co-registered or fused. Image fusion is associated with the error that can distort the location of anatomical structures. Co-registration in DBS surgery is usually performed automatically by proprietary software; the amount of error during this process is not well understood. Here, our goal is to quantify the error during automated image co-registration with FrameLink™, a commonly used software for DBS planning and clinical research. Methods: This is a single-center retrospective study at a quaternary care referral center, comparing CT and MR imaging co-registration for a consecutive series of patients over a 12-month period. We collected CT images and MRI scans for 22 patients with Parkinson’s disease requiring placement of DBS. Anatomical landmarks were located on CT images and MRI scans using a novel image analysis algorithm that included a method for capturing the potential error inherent in the image standardization step of the analysis. The distance between the anatomical landmarks was measured, and the error was found by averaging the distances across all patients. Results: The average error during co-registration was 1.25 mm. This error was significantly larger than the error resulting from image standardization (0.19 mm) and was worse in the anterior-posterior direction. Conclusions: The image fusion errors found in this analysis were nontrivial. Although the estimated error may be inflated, it is significant enough that users must be aware of this potential inaccuracy, and developers of proprietary software should provide details about the magnitude and direction of co-registration errors.

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Preliminary experience with an intraoperative MRI-compatible infant headholder: technical note

Cited by 11 publications

References 23 publications

The impact of 1.5-T intraoperative magnetic resonance imaging in pediatric tumor surgery: Safety, utility, and challenges

The impact of 1.5-T intraoperative magnetic resonance imaging in pediatric tumor surgery: Safety, utility, and challenges

Feasibility of intraoperative MRI for endovascular coiling of intracranial aneurysms: A single centre experience

CT and MRI Image Fusion Error: An Analysis of Co-Registration Error Using Commercially Available Deep Brain Stimulation Surgical Planning Software

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