Usefulness of Intraoperative Computed Tomography in Surgery for Low-Grade Gliomas: a Comparative Study Between Two Series Without and With Intraoperative Computed Tomography

Hosoda, Tetsuya; Takeuchi, Hiroaki; Hashimoto, Norichika; Kitai, Ryuhei; Arishima, Hidetaka; Kodera, Toshiaki; Higashino, Yoshifumi; Sato, Kazufumi; Kikuta, Ken-ichiro

doi:10.2176/nmc.51.490

Cited by 25 publications

(18 citation statements)

References 19 publications

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“…1C, D). Hosoda et al3) reported that surgical resection with intraoperative CT prolongs survival by acquiring more complete surgical resection, which was confirmed during or immediately after the procedure.…”

Section: Discussionmentioning

confidence: 93%

Mobile Computed Tomography : Three Year Clinical Experience in Korea

Jeon

Lee

Son

et al. 2013

J Korean Neurosurg Soc

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ObjectiveObtaining real-time image is essential for neurosurgeons to minimize invasion of normal brain tissue and to prompt diagnosis of intracranial event. The aim of this study was to report our three-year experience with a mobile computed tomography (mCT) for intraoperative and bedside scanning.MethodsA total of 357 mCT (297 patients) scans from January 2009 to December 2011 in single institution were reviewed. After excluding post-operative routine follow-up, 202 mCT were included for analysis. Their medical records such as diagnosis, clinical application, impact on decision making, times, image quality and radiologic findings were assessed.ResultsTwo-hundred-two mCT scans were performed in the operation room (n=192, 95%) or intensive care unit (ICU) (n=10, 5%). Regarding intraoperative images, extent of resection of tumor (n=55, 27.2%), degree of hematoma removal (n=42, 20.8%), confirmation of catheter placement (n=91, 45.0%) and monitoring unexpected complications (n=4, 2.0%) were evaluated. A total of 14 additional procedures were introduced after confirmation of residual tumor (n=7, 50%), hematoma (n=2, 14.3%), malpositioned catheter (n=3, 21.4%) and newly developed intracranial events (n=2, 14.3%). Every image was obtained within 15 minutes and image quality was sufficient for interpretation.ConclusionmCT is feasible for prompt intraoperative and ICU monitoring with enhanced diagnostic certainty, safety and efficiency.

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Section: Discussionmentioning

confidence: 93%

Mobile Computed Tomography : Three Year Clinical Experience in Korea

Jeon

Lee

Son

et al. 2013

J Korean Neurosurg Soc

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“…Yes, depending on the sequence 22 Yes 20 Yes, although orientation is limited owing to the different planes 23,24 2D/3D 3D 3D 2D, 3D with specialized transducers or a stacked 2D volume 23 Need for contrast agent Not necessary; discrimination between two types of tissue can be improved with the use of contrast agent and it gives the opportunity to acquire real-time vascular-phase images 22,25 Not necessary; discrimination between two types of tissue can be improved 26 Not necessary; discrimination between two types of tissue can be improved and real-time vascular-phase images acquired 27,28 Cost (machine and facility) €€€ 22 24,27 . Delay is dependent on operator (maximum a few minutes) 23…”

Section: Anatomical Informationmentioning

confidence: 99%

“…Yes, highly interfering. Positionwise may even be impossible 22 Yes, depending on the modality and the possibility of a sliding gantry on a railtrack 24,26 Not in general and presents no logistical challenges 23 . Yes, it needs direct contact with specimen 4,21…”

Section: Interference With Surgerymentioning

confidence: 99%

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Modalities for image- and molecular-guided cancer surgery

Stammes

Bugby

Porta

et al. 2018

British Journal of Surgery

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Background: Surgery is the cornerstone of treatment for many solid tumours. A wide variety of imaging modalities are available before surgery for staging, although surgeons still rely primarily on visual and haptic cues in the operating environment. Image and molecular guidance might improve the adequacy of resection through enhanced tumour definition and detection of aberrant deposits. Intraoperative modalities available for image-and molecular-guided cancer surgery are reviewed here.Methods: Intraoperative cancer detection techniques were identified through a systematic literature search, with selection of peer-reviewed publications from January 2012 to January 2017. Modalities were reviewed, described and compared according to 25 predefined characteristics. To summarize the data in a comparable way, a three-point rating scale was applied to quantitative characteristics. Results:The search identified ten image-and molecular-guided surgery techniques, which can be divided into four groups: conventional, optical, nuclear and endogenous reflectance modalities. Conventional techniques are the most well known imaging modalities, but unfortunately have the drawback of a defined resolution and long acquisition time. Optical imaging is a real-time modality; however, the penetration depth is limited. Nuclear modalities have excellent penetration depth, but their intraoperative use is limited by the use of radioactivity. Endogenous reflectance modalities provide high resolution, although with a narrow field of view. Conclusion:Each modality has its strengths and weaknesses; no single technique will be suitable for all surgical procedures. Strict selection of modalities per cancer type and surgical requirements is required as well as combining techniques to find the optimal balance.

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“…It is also possible to use the intraoperative CT data to align it to the preoperative CT or MRI dataset. This is typically not the preferred method for brain tumor surgery due to the disadvantages of exposure to ionizing radiation, and poor soft tissue delineation, but some groups have explored its use [55,88]. Haberland et al [76] also used iCT in combination with iUS.…”

Section: Intraoperative Ctmentioning

confidence: 99%

Guidance and Visualization for Brain Tumor Surgery

Marreiros¹,

Miguel²

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Image guidance and visualization play an important role in modern surgery to help surgeons perform their surgical procedures. Here, the focus is on neurosurgery applications, in particular brain tumor surgery where a craniotomy (opening of the skull) is performed to access directly the brain region to be treated. In this type of surgery, once the skull is opened the brain can change its shape, and this deformation is known as brain shift. Moreover, the boundaries of many types of tumors are difficult to identify by the naked eye from healthy tissue. The main goal of this work was to study and develop image guidance and visualization methods for tumor surgery in order to overcome the problems faced in this type of surgery.Due to brain shift the magnetic resonance dataset acquired before the operation (preoperatively) no longer corresponds to the anatomy of the patient during the operation (intraoperatively). For this reason, in this work methods were studied and developed to compensate for this deformation. To guide the deformation methods, information of the superficial vessel centerlines of the brain was used. A method for accurate (approximately 1 mm) reconstruction of the vessel centerlines using a multiview camera system was developed. It uses geometrical constraints, relaxation labeling, thin plate spline filtering and finally mean shift to find the correct correspondences between the camera images.A complete non-rigid deformation pipeline was initially proposed and evaluated with an animal model. From these experiments it was observed that although the traditional non-rigid registration methods (in our case coherent point drift) were able to produce satisfactory vessel correspondences between preoperative and intraoperative vessels, in some specific areas the results were suboptimal. For this reason a new method was proposed that combined the coherent point drift and thin plate spline semilandmarks. This combination resulted in an accurate (below 1 mm) non-rigid registration method, evaluated with simulated data where artificial deformations were performed.Besides the non-rigid registration methods, a new rigid registration method to obtain the rigid transformation between the magnetic resonance dataset and the neuronavigation coordinate systems was also developed.Once the rigid transformation and the vessel correspondences are known, i the thin plate spline can be used to perform the brain shift deformation. To do so, we have used two approaches: a direct and an indirect. With the direct approach, an image is created that represents the deformed data, and with the indirect approach, a new volume is first constructed and only after that can the deformed image be created. A comparison of these two approaches, implemented for the graphics processing units, in terms of performance and image quality, was performed. The indirect method was superior in terms of performance if the sampling along the ray is high, in comparison to the voxel grid, while the direct was superior otherwise. The image quality an...

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Usefulness of Intraoperative Computed Tomography in Surgery for Low-Grade Gliomas: a Comparative Study Between Two Series Without and With Intraoperative Computed Tomography

Cited by 25 publications

References 19 publications

Mobile Computed Tomography : Three Year Clinical Experience in Korea

Mobile Computed Tomography : Three Year Clinical Experience in Korea

Modalities for image- and molecular-guided cancer surgery

Guidance and Visualization for Brain Tumor Surgery

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