Intra-operative Imaging Techniques During Surgical Management of Gliomas

The goal of glioma surgery is to maximize tumor removal while preserving existing function. Intra-operative imaging techniques play an important part in achieving this goal. This article surveys those techniques and discusses the indications, advantages, and drawbacks of each. Structural techniques such as intra-operative magnetic resonance imaging (MRI), ultrasound, diffusion tensor imaging, and 5-aminolevulinic acid staining offer anatomic information. Functional techniques such as functional MRI, magnetoencephalography, and transcranial magnetic stimulation provide information about the functionality of brain regions. When incorporated into a frameless stereotactical neuronavigation system, these modalities increase both the efficacy and safety of glioma surgery by allowing the surgeon to achieve the most extensive and safe resection possible.

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Intra-operative Imaging Techniques During Surgical Management of Gliomas

European Neurological Review ◽

10.17925/enr.2012.07.01.76 ◽

2012 ◽

Vol 7 (1) ◽

pp. 76 ◽

Cited By ~ 1

Author(s):

Phiroz E Tarapore ◽

Edward F Chang ◽

Mitchel S Berger ◽

◽

...

Keyword(s):

Aminolevulinic Acid ◽

Diffusion Tensor ◽

Imaging Techniques ◽

Brain Regions ◽

Glioma Surgery ◽

Tumour Removal ◽

Neuronavigation System ◽

Magnetic Resonance Imaging Mri ◽

Anatomical Information ◽

Information Functional

The goal of glioma surgery is to maximise tumour removal while preserving existing function. Intra-operative imaging techniques play an important part in achieving this goal. This article surveys those techniques and discusses the indications, advantages and drawbacks of each. Structural techniques such as intra-operative magnetic resonance imaging (MRI), ultrasound, diffusion tensor imaging and 5-aminolevulinic acid staining offer anatomical information. Functional techniques such as functional MRI, magnetoencephalography and transcranial magnetic stimulation provide information about the functionality of brain regions. When incorporated into a frameless stereotactical neuronavigation system, these modalities increase both the efficacy and safety of glioma surgery by allowing the surgeon to achieve the most extensive and safe resection possible.

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MS-2 Minimally invasive glioma surgery with navigation system and tubular retractor

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa143.009 ◽

2020 ◽

Vol 2 (Supplement_3) ◽

pp. ii2-ii3

Author(s):

Kazuhiko Kurozumi

Keyword(s):

Navigation System ◽

Diffusion Tensor ◽

Therapeutic Option ◽

Normal Brain ◽

Navigation Systems ◽

Glioma Surgery ◽

Tubular Retractor ◽

Neuronavigation System ◽

Magnetic Resonance Imaging Mri ◽

Neurological Surgery

Abstract Navigation systems are reliable and safe for neurological surgery. Navigation is an attractive and innovative therapeutic option. Recently, endo and exoscopic surgeries have been gradually increasing in neurosurgery. We are currently trialing to use 4K and 8K systems to improve the accuracy and safety of our surgical procedures. Surgeries for deep-seated tumors are challenging because of the difficulty in creating a corridor and observing the interface between lesions and the normal area. In total, 315 patients underwent surgery at Okayama University between 2017 and 2019. Among them, we experienced 92 glioma surgeries using navigation systems. Preoperatively, we performed computed tomography imaging and contrast-enhanced magnetic resonance imaging (MRI) for the neuronavigation system. We experienced Curve(TM) Image Guided Surgery (BrainLab, Munich, Germany). The surgical trajectory was planned with functional MRI and diffusion tensor imaging to protect the eloquent area and critical vasculature of the brain. We used a clear plastic tubular retractor system, the ViewSite Brain Access System, for surgery of deep seated gliomas. We gently inserted and placed the ViewSite using the neuronavigation. The tumor was observed and resected through the ViewSite tubular retractor under a microscope and endoscope. If the tumor was large, we switched the ViewSite tubular retractor to brain spatulas to identify the boundary between the normal brain and lesion. We are currently using the combination of the tubular retractor and brain spatulas using navigation system. Here, we present and analyze our preoperative simulation, surgical procedure, and outcomes.

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In vivo imaging techniques: a new era for histochemical analysis

European Journal of Histochemistry ◽

10.4081/ejh.2016.2725 ◽

2016 ◽

Cited By ~ 6

Author(s):

A. Busato ◽

P. Fumene Feruglio ◽

P.P. Parnigotto ◽

P. Marzola ◽

A. Sbarbati

Keyword(s):

Magnetic Resonance ◽

In Vivo Imaging ◽

Diffusion Tensor ◽

Technological Development ◽

Imaging Techniques ◽

Resonance Spectroscopy ◽

Preclinical Research ◽

Tissue Contrast ◽

Magnetic Resonance Imaging Mri

In vivo imaging techniques can be integrated with classical histochemistry to create an actual histochemistry of water. In particular, Magnetic Resonance Imaging (MRI), an imaging technique primarily used as diagnostic tool in clinical/preclinical research, has excellent anatomical resolution, unlimited penetration depth and intrinsic soft tissue contrast. Thanks to the technological development, MRI is not only capable to provide morphological information but also and more interestingly functional, biophysical and molecular. In this paper we describe the main features of several advanced imaging techniques, such as MRI microscopy, Magnetic Resonance Spectroscopy, functional MRI, Diffusion Tensor Imaging and MRI with contrast agent as a useful support to classical histochemistry.

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Contemporary intraoperative visualization for GBM with use of exoscope, 5-ALA fluorescence-guided surgery and tractography

Neurosurgical Focus: Video ◽

10.3171/2021.10.focvid21174 ◽

2022 ◽

Vol 6 (1) ◽

pp. V5

Keyword(s):

Diffusion Tensor ◽

High Grade Glioma ◽

Brain Regions ◽

High Grade ◽

Glioma Surgery ◽

Guided Surgery ◽

Word Finding ◽

Patient Consent ◽

Dti Fiber Tracking ◽

Intraoperative Visualization

Maximal safe resection is the primary goal of glioma surgery. By incorporating improved intraoperative visualization with the 3D exoscope combined with 5-ALA fluorescence, in addition to neuronavigation and diffusion tensor imaging (DTI) fiber tracking, the safety of resection of tumors in eloquent brain regions can be maximized. This video highlights some of the various intraoperative adjuncts used in brain tumor surgery for high-grade glioma. In this case, the authors highlight the resection of a left posterior temporal lobe high-grade glioma in a 33-year-old patient, who initially presented with seizures, word-finding difficulty, and right-sided weakness. They demonstrate the multiple surgical adjuncts used both before and during surgical resection, and how multiple adjuncts can be effectively orchestrated to make surgery in eloquent brain areas safer for patients. Patient consent was obtained for publication. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21174

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Diffusion Tensor Imaging and Fiber Tractography

Handbook of Research on Advanced Techniques in Diagnostic Imaging and Biomedical Applications ◽

10.4018/978-1-60566-314-2.ch015 ◽

2009 ◽

pp. 229-246

Author(s):

Evanthia E. Tripoliti ◽

Dimitrios I. Fotiadis ◽

Konstantia Veliou

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Diffusion Tensor ◽

Brain Regions ◽

Cerebral White Matter ◽

Tissue Microstructure ◽

Diffusion Weighted Images ◽

Fiber Tracts ◽

Diffusion Weighted ◽

Magnetic Resonance Imaging Mri

Diffusion Tensor Imaging (DTI) is a magnetic resonance imaging (MRI) modality which can significantly improve our understanding of the brain structures and neural connectivity. DTI measures are thought to be representative of brain tissue microstructure and are particularly useful for examining organized brain regions, such as white matter tract areas. DTI measures the water diffusion tensor using diffusion weighted pulse sequences which are sensitive to microscopic random water motion. The resulting diffusion weighted images (DWI) display and allow quantification of how water diffuses along axes or diffusion encoding directions. This can help to measure and quantify the tissue’s orientation and structure, making it an ideal tool for examining cerebral white matter and neural fiber tracts. In this chapter the authors discuss the theoretical aspects of DTI, the information that can be extracted from DTI data, and the use of the extracted information for the reconstruction of fiber tracts and the diagnosis of a disease. In addition, a review of known fiber tracking algorithms is presented.

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Functional preoperative and intraoperative mapping and monitoring: increasing safety and efficacy in glioma surgery

Neurosurgical FOCUS ◽

10.3171/2014.10.focus14611 ◽

2015 ◽

Vol 38 (1) ◽

pp. E3 ◽

Cited By ~ 71

Author(s):

Malte Ottenhausen ◽

Sandro M. Krieg ◽

Bernhard Meyer ◽

Florian Ringel

Keyword(s):

Diffusion Tensor ◽

Imaging Techniques ◽

Extent Of Resection ◽

Low Grade ◽

Glioma Surgery ◽

Intraoperative Mapping ◽

Fiber Tracts ◽

Functional Localization ◽

Eloquent Cortex ◽

Cortical Regions

Greater extent of resection (EOR) of low-grade gliomas is associated with improved survival. Proximity to eloquent cortical regions often limits resectability and elevates the risk of surgery-related deficits. Therefore, functional localization of eloquent cortex or subcortical fiber tracts can enhance the EOR and functional outcome. Imaging techniques such as functional MRI and diffusion tensor imaging fiber tracking, and neurophysiological methods like navigated transcranial magnetic stimulation and magnetoencephalography, make it possible to identify eloquent areas prior to resective surgery and to tailor indication and surgical approach but also to assess the surgical risk. Intraoperative monitoring with direct cortical stimulation and subcortical stimulation enables surgeons to preserve essential functional tissue during surgery. Through tailored pre- and intraoperative mapping and monitoring the EOR can be maximized, with reduced rates of surgery-related deficits.

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Possible confounding factors on cerebral diffusion tensor imaging measurements

Acta Radiologica Open ◽

10.1177/2047981614546795 ◽

2015 ◽

Vol 4 (2) ◽

pp. 204798161454679 ◽

Cited By ~ 1

Author(s):

Miina Nenonen ◽

Ullamari Hakulinen ◽

Antti Brander ◽

Juha Ohman ◽

Prasun Dastidar ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

Alcohol Consumption ◽

Diffusion Tensor ◽

Region Of Interest ◽

Brain Regions ◽

Education History ◽

Confounding Factors ◽

Consistent Finding ◽

Apparent Diffusion ◽

Magnetic Resonance Imaging Mri

Background Diffusion tensor imaging (DTI) is prone to numerous systemic confounding factors that should be acknowledged to avoid false conclusions. Purpose To investigate the possible effects of age, gender, smoking, alcohol consumption, and education on cerebral DTI parameters in a generally healthy homogenous sample with no neurological or psychiatric diseases. Material and Methods Forty ( n = 40) subjects (mean age, 40.3 years; SD, 12.3) underwent brain DTI with 3 T magnetic resonance imaging (MRI). At enrolment, all the subjects were interviewed with respect to general health, education, history of smoking, and alcohol consumption. Studied DTI parameters included: (i) fractional anisotropy (FA); and (ii) apparent diffusion coefficient (ADC). Region-of-interest (ROI)-based measurements were estimated at 13 anatomical locations bilaterally on the axial images, except for the corpus callosum in which the ROIs were placed on the sagittal images. Circular ROI measurements were mainly used. Freehand ROI method was used with the forceps minor, uncinate fasciculus, and thalamus. Intra-observer variability and repeatability were assessed. Results The most consistent finding was that aging decreased FA values in the frontal brain regions. Regarding the other confounding factors, the results were discontinuous and no concrete conclusions could be drawn from these findings. In general, intra-observer repeatability of the DTI measurement was considered relatively good. Conclusion Age should be noted as considerable confounding factors in ROI-based DTI analysis. More research on the effects of gender, smoking, alcohol consumption, and education is needed.

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Diffusion kurtosis imaging of white matter in bipolar disorder

10.1101/2021.02.01.21250951 ◽

2021 ◽

Author(s):

Vina M Goghari ◽

Mavis Kusi ◽

Mohammed K Shakeel ◽

Clare Beasley ◽

Szabolcs David ◽

...

Keyword(s):

Bipolar Disorder ◽

White Matter ◽

Diffusion Tensor ◽

Brain Regions ◽

Diffusion Kurtosis Imaging ◽

Simple Diffusion ◽

Spherical Deconvolution ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Diffusion Kurtosis

AbstractObjectivesWhite matter pathology is thought to contribute to the pathogenesis of bipolar disorder (BD). However, most studies of white matter in BD have used the simple diffusion tensor imaging (DTI) model, which has several limitations. DTI studies have reported heterogenous results, leading to a lack of consensus about the extent and location of white matter alterations. Here, we applied two advanced diffusion magnetic resonance imaging (MRI) techniques to investigate white matter microstructure in BD.MethodsTwenty-five patients with BD and 24 controls comparable for age and sex were included in the study. Whole-brain voxel-based analysis (VBA) and a network-based connectivity approach using constrained spherical deconvolution (CSD)-tractography were used to assess group differences in diffusion kurtosis imaging (DKI) and DTI metrics.ResultsVBA showed lower mean kurtosis in the corona radiata and posterior association fibers in BD following threshold-free cluster enhancement. Regional differences in connectivity were indicated by lower mean kurtosis and kurtosis anisotropy in streamlines traversing the temporal and occipital lobes, and lower mean axial kurtosis in the right cerebellar, thalamo-subcortical pathways in BD. Significant differences were not seen in the DTI metrics following FDR- correction.ConclusionsDifferences between BD and controls were observed in DKI metrics in multiple brain regions, indicating altered connectivity across cortical, subcortical and cerebellar areas. DKI was more sensitive than DTI at detecting these differences, suggesting that DKI is useful for investigating white matter in BD.

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Advanced techniques in magnetic resonance imaging of the brain in children with ADHD

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2011000200020 ◽

2011 ◽

Vol 69 (2a) ◽

pp. 242-252 ◽

Cited By ~ 10

Author(s):

Giuseppe Pastura ◽

Paulo Mattos ◽

Emerson Leandro Gasparetto ◽

Alexandra Prufer de Queiroz Campos Araújo

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cortical Thickness ◽

Diffusion Tensor ◽

Brain Regions ◽

Resonance Imaging ◽

Brain Volumetry ◽

Aged Child ◽

Magnetic Resonance Imaging Mri ◽

The Brain

Attention deficit hyperactivity disorder (ADHD) affects about 5% of school-aged child. Previous published works using different techniques of magnetic resonance imaging (MRI) have demonstrated that there may be some differences between the brain of people with and without this condition. This review aims at providing neurologists, pediatricians and psychiatrists an update on the differences between the brain of children with and without ADHD using advanced techniques of magnetic resonance imaging such as diffusion tensor imaging, brain volumetry and cortical thickness, spectroscopy and functional MRI. Data was obtained by a comprehensive, non-systematic review of medical literature. The regions with a greater number of abnormalities are splenium of the corpus callosum, cingulated girus, caudate nucleus, cerebellum, striatum, frontal and temporal cortices. The brain regions where abnormalities are observed in studies of diffusion tensor, volumetry, spectroscopy and cortical thickness are the same involved in neurobiological theories of ADHD coming from studies with functional magnetic resonance imaging.

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TRACER: A toolkit to register and visualize anatomical coordinates in the rat brain

10.1101/2021.10.01.462770 ◽

2021 ◽

Author(s):

Jacopo Paglia ◽

Pearl Saldanha ◽

Jingyi Guo Fuglstad ◽

Jonathan R. Whitlock

Keyword(s):

Rat Brain ◽

Diffusion Tensor ◽

Brain Regions ◽

Brain Atlas ◽

Novel Technologies ◽

Digital Reconstruction ◽

Magnetic Resonance Imaging Mri ◽

Virus Expression ◽

3D Volume ◽

Post Hoc

The need for anatomical registration and visualization tools is greater than ever thanks to novel technologies that allow users to record from thousands of neurons across multiple brain regions simultaneously. The vast majority of digital reconstruction toolkits for rodent models were developed using mouse brain atlases, leaving few options for those using rats. Retrofitting rat atlases into extant software is possible, but this demands effort and programming skills which most end-users lack. We therefore developed an open-source, python-based Toolkit for Reconstructing Anatomical CoordinatEs in Rats, TRACER, which allows users to reconstruct the trajectories of recording electrodes (e.g Neuropixels) or to visualize virus expression or other features in a comprehensively annotated 3D volume, the Waxholm Space (WHS) rat brain atlas. The WHS atlas is made from high-resolution magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) scans, and contains >200 regional delineations. Beyond post-hoc reconstructions of electrodes or virus expression, TRACER can be used to generate coordinates for targeting brain regions prior to surgery. TRACER is available openly on GitHub and is compatible with Windows, macOS and Linux operating systems.

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