scholarly journals Neurosurgery and brain shift: review of the state of the art and main contributions of robotics

TecnoLógicas ◽  
2017 ◽  
Vol 20 (40) ◽  
pp. 125-138
Author(s):  
Karin Correa-Arana ◽  
Oscar A. Vivas-Albán ◽  
José M. Sabater-Navarro
Keyword(s):  
Brain Tumor ◽  
State Of The Art ◽  
Image Guided Surgery ◽  
Medical Procedures ◽  
Brain Shift ◽  
Future Perspectives ◽  
Guided Surgery ◽  
Image Guided ◽  
Neuronavigation System ◽  
Minimal Invasion

This paper presents a review about neurosurgery, robotic assistants in this type of procedure, and the approach to the problem of brain tissue displacement, including techniques for obtaining medical images. It is especially focused on the phenomenon of brain displacement, commonly known as brain shift, which causes a loss of reference between the preoperative images and the volumes to be treated during image-guided surgery. Hypothetically, with brain shift prediction and correction for the neuronavigation system, minimal invasion trajectories could be planned and shortened. This would reduce damage to functional tissues and possibly lower the morbidity and mortality in delicate and demanding medical procedures such as the removal of a brain tumor. This paper also mentions other issues associated with neurosurgery and shows the way robotized systems have helped solve these problems. Finally, it highlights the future perspectives of neurosurgery, a branch of medicine that seeks to treat the ailments of the main organ of the human body from the perspective of many disciplines.

scholarly journals Real-Time Imaging of Brain Tumor for Image-Guided Surgery

2018 ◽  
Vol 7 (16) ◽  
pp. 1800066 ◽  
Author(s):  
Shuang Hu ◽  
Homan Kang ◽  
Yoonji Baek ◽  
Georges El Fakhri ◽  
Anren Kuang ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Real Time ◽  
Image Guided Surgery ◽  
Real Time Imaging ◽  
Guided Surgery ◽  
Image Guided

Evaluation of factors predicting accurate resection of high-grade gliomas by using frameless image-guided stereotactic guidance

2003 ◽  
Vol 14 (2) ◽  
pp. 1-4 ◽  
Author(s):  
Ronald Benveniste ◽  
Isabelle M. Germano
Keyword(s):  
Mr Imaging ◽  
Extent Of Resection ◽  
Image Guided Surgery ◽  
High Grade ◽  
Brain Shift ◽  
Patient Age ◽  
Guided Surgery ◽  
Image Guided ◽  
Patient Âgé ◽  
High Grade Gliomas

Object Frameless image-guided stereotaxy is often used in the resection of high-grade gliomas. The authors of several studies, however, have suggested that brain shift may occur intraoperatively and result in inaccurate resection. To determine the usefulness of frameless stereotactic image-guided surgery of high-grade gliomas, the authors correlated factors predictive of brain shift, such as tumor size, periventricular location, and patient age (as an indicator of brain atrophy) with the extent of resection. Methods Inclusion criteria included the following: 1) stereotactic volumetric craniotomy for resection of tumor; 2) histologically proven high-grade glioma; 3) preoperative magnetic resonance (MR) imaging demonstration of an enhancing portion of tumor; 4) postoperative MR imaging within 48 hours to assess the extent of resection; and 5) preoperative intention to perform gross-total resection of the enhancing tumor. Fifty-four patients met these criteria between September 1997 and November 2002. Accurate resection was considered to be indicated by a lack of nodular enhancement on postoperative Gd-enhanced MR images obtained within 48 hours of surgery. Frameless stereotactic image-guided surgery resulted in the successful resection of 46 (85%) of 54 high-grade gliomas. Accurate resection was significantly more likely with tumors less than 30 ml in volume than with those greater than 30 ml (93 and 58%, respectively [p < 0.05]). In addition, small periventricular tumors were associated with significant less successful resection compared with nonperiventricular tumor (77 and 96%, respectively [p = 0.5]). Patient age did not affect the likelihood of successful resection. Conclusions Frameless image-guided stereotactic techniques can be reliably used for accurate resection of high-grade gliomas when the tumor is less than 30 ml in volume and not adjacent to the ventricular system. In cases involving tumors larger in volume or located near the ventricles, intraoperative ultrasonography or MR imaging updates should be considered.

ALA-induced PpIX spectroscopy for brain tumor image-guided surgery

2011 ◽  
Author(s):  
Pablo A. Valdes ◽  
Frederic Leblond ◽  
Anthony Kim ◽  
Brent T. Harris ◽  
Brian C. Wilson ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Image Guided Surgery ◽  
Guided Surgery ◽  
Image Guided

Image guided surgery versus conventional brain tumor and craniotomy localization

2016 ◽  
Vol 61 (1) ◽  
Author(s):  
Mehran Mahvash ◽  
Ioannis Boettcher ◽  
Athanasios K. Petridis ◽  
Leila Besharati Tabrizi
Keyword(s):  
Brain Tumor ◽  
Image Guided Surgery ◽  
Guided Surgery ◽  
Image Guided

ITVT-04. Management of intraoperative technological advances [intraoperative MRI, neuronavigation system using PET, and 5-aminolevulinic acid (5-ALA)–induced fluorescence image-guided surgery] for glioblastoma

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi228-vi228
Author(s):  
Keisuke Miyake ◽  
Daisuke Ogawa ◽  
Tetsuhiro Hatakeyama
Keyword(s):  
Aminolevulinic Acid ◽  
Tumor Resection ◽  
Intraoperative Mri ◽  
Metabolic Imaging ◽  
Image Guided Surgery ◽  
Residual Volume ◽  
Guided Surgery ◽  
Image Guided ◽  
Neuronavigation System ◽  
Fluorescence Level

Abstract OBJECTIVE The maximum resection of Glioblastoma (GBM) is the standard therapy and is expected to improve prognosis. Image-guided surgery using a neuronavigation system is the standard technique for glioma. However, due to the brain shift during surgery, intraoperative technologies, such as 5-ALA fluorescence and intraoperative MRI (IoMRI), are employed. Radiotracers are used during positron emission tomography (PET) for metabolic imaging and assist the evaluation of glioma metabolism. We compared the effectiveness of these intraoperative technologies. METHODS Between January 2016 and May 2021, 52 patients with gliomas underwent IoMRI. 21 patients were selected for 5-ALA fluorescence-guided resection of GBM and underwent multiple PET studies (MET, FLT, and FMISO). We graded fluorescence level as strong, vague, or none. Following tumor resection, we identified the fluorescence level and evaluated the residual volume of gadolinium-enhanced T1WI (T1-Gd) on IoMRI and at each PET study. After calculating the extent of resection (EOR) for T1-Gd, we compared the residual volume on T1-Gd for IoMRI and each PET study, between EOR ≥ 93% and EOR &lt; 93%. RESULTS We detected strong 5-ALA fluorescence during induction and before tumor resection in all 21 (100%) patients with a newly-diagnosed and histopathologically-confirmed GBM. Following tumor resection, we noted an EOR ≥ 93% for T1-Gd in 12 cases (vague, 4; none, 8) and an EOR &lt; 93% for T1-Gd in 9 cases (vague, 5; none, 4). The compared median residual volume (mL) with no fluorescence between EOR ≥ 93% and EOR &lt; 93% for T1-Gd were T1-Gd (0.22, 0.74), MET (0.29, 3.31), FLT (0.24, 1.77), and FMISO (0.22, 1.02). CONCLUSIONS GBM cells are difficult to distinguish in cases without 5-ALA fluorescence. For cases without 5-ALA fluorescence, we were able to maximize the resection of GBM by extracting the area of MET accumulation.

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