Tractography Methods in Preoperative Neurosurgical Planning

ABSTRACT OBJECTIVE The purpose of this investigation was to determine whether clinical speech deficits after brain injury are associated with functional speech reorganization. METHODS Across an 18-year interval, 11 patients with mild-to-moderate speech deficits underwent language mapping as part of their treatment for intractable epilepsy. These “aphasics” were compared with 14 matched “control” patients with normal speech who also were undergoing epilepsy surgery. Neuroanatomic data were compared with quantitative language profiles and clinical variables. RESULTS Cortical lesions were evident near speech areas in all aphasia cases. As expected, aphasic and control patients were distinguished by quantitative language profiles. The groups were further distinguished by the anatomic distribution of their speech sites. A significantly greater proportion of frontal speech sites was found in patients with previous brain injury, consistent with frontal site recruitment. The degree of frontal recruitment varied as a function of patient age at the time of initial brain injury; earlier injuries were associated with greater recruitment. The overall number of speech sites remained the same after injury. Significant associations were found between the number of the speech sites, naming fluency, and the lesion proximity in the temporal lobe. CONCLUSION Language maps in aphasics demonstrated evidence for age-dependent functional recruitment in the frontal, but not temporal, lobe. The proximity of cortical lesions to temporal speech sites predicted the overall extent of temporal lobe speech representation and performance on naming fluency. These findings have implications for neurosurgical planning in patients with preoperative speech deficits.

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A COLLABORATIVE VIRTUAL REALITY ENVIRONMENT FOR NEUROSURGICAL PLANNING AND TRAINING

Operative Neurosurgery ◽

10.1227/01.neu.0000303997.12645.26 ◽

2007 ◽

Vol 61 ◽

pp. 379-391 ◽

Cited By ~ 23

Author(s):

Ralf A. Kockro ◽

Axel Stadie ◽

Eike Schwandt ◽

Robert Reisch ◽

Cleopatra Charalampaki ◽

...

Keyword(s):

Virtual Reality ◽

Virtual Reality Environment ◽

Collaborative Virtual Reality ◽

Neurosurgical Planning ◽

And Training

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Multimodal Risk-Based Path Planning for Neurosurgical Interventions

Journal of Medical Devices ◽

10.1115/1.4049550 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Christian Kunz ◽

Maximilian Gerst ◽

Pit Henrich ◽

Max Schneider ◽

Michal Hlavac ◽

...

Keyword(s):

User Interaction ◽

Qualitative Evaluation ◽

Modular Architecture ◽

Holistic Model ◽

Planning Time ◽

Inherent Risk ◽

Complex Anatomy ◽

Neurosurgical Planning ◽

Quantitative Performance ◽

The Brain

Abstract Image-guided neurosurgical interventions are challenging due to the complex anatomy of the brain and the inherent risk of damaging vital structures. This paper presents a neurosurgical planning tool for safe and effective neurosurgical interventions, minimizing the risk through optimized access planning. The strengths of the proposed system are the integration of multiple risk structures combined into a holistic model for fast and intuitive user interaction, and a modular architecture. The tool is intended to support neurosurgeons to quickly determine the most appropriate surgical entry point and trajectory through the brain with minimized risk. The user interface guides a user through the decision-making process and may save planning time of neurosurgical interventions. The navigation tool has been interfaced to the Robot Operating System, which allows the integration into automated workflows and the planning of linear and nonlinear trajectories. Determined risk structures and trajectories can be visualized intuitively as a projection map on the skin or cortical surface. Two risk calculation modes (strict and joint) are offered to the neurosurgeons, depending on the intracranial procedure's type and complexity. A qualitative evaluation with clinical experts shows the practical relevance, while a quantitative performance and functionality analysis proves the robustness and effectiveness of the system.

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Visualisation of Multimodal Images for Neurosurgical Planning and Guidance

Lecture Notes in Computer Science - Computer Vision, Virtual Reality and Robotics in Medicine ◽

10.1007/978-3-540-49197-2_5 ◽

1995 ◽

pp. 40-46

Author(s):

J. Zhao ◽

A. C. F. Colchester ◽

C. J. Henri ◽

D. Hawkes ◽

C. Ruff

Keyword(s):

Neurosurgical Planning ◽

Multimodal Images

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DTI and Tractography in Neurosurgical Planning

Diffusion MRI ◽

10.1093/med/9780195369779.003.0036 ◽

2010 ◽

pp. 588-607

Author(s):

Christopher A. Clark ◽

Tiernan Byrnes

Keyword(s):

Neurosurgical Planning

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VOLUME VISUALIZATION FOR SURGICAL PLANNING SYSTEM

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519407002133 ◽

2007 ◽

Vol 07 (01) ◽

pp. 55-63 ◽

Cited By ~ 2

Author(s):

CHAN CHEE FATT ◽

IRWAN KASSIM ◽

CHARLES LO ◽

IVAN NG ◽

KWOH CHEE KEONG

Keyword(s):

Computer Technology ◽

Surgical Approach ◽

Surgical Planning ◽

Volume Visualization ◽

Planning System ◽

Neurosurgical Planning ◽

2D Imaging ◽

3D Volume ◽

Volume Models

The 3D volume visualization is to overcome the difficulties of the 2D imaging by using computer technology. A volume visualization approach has been successfully implemented for Surgical Planning System in National Neuroscience Institute (NNI). The system allows surgeons to plan a surgical approach on a set of 2D image slices and process into volume models and visualise them in 3D rapidly and interactively on PC. In our implementation, we have applied it in neurosurgical planning. The surgeon can visualize objects of interest like tumor and surgical path, and verify that the surgical plan avoids the critical features and the planning of the surgical path can thus be optimal.

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Functional brain mapping using positron emission tomography scanning in preoperative neurosurgical planning for pediatric brain tumors

Neurosurgical FOCUS ◽

10.3171/foc.2000.8.2.5 ◽

2000 ◽

Vol 8 (2) ◽

pp. 1-7

Author(s):

Allen M. Kaplan ◽

Daniel J. Bandy ◽

Kim H. Manwaring ◽

Kewei Chen ◽

Michael A. Lawson ◽

...

Keyword(s):

Positron Emission Tomography ◽

Brain Tumors ◽

Pet Imaging ◽

Brain Mapping ◽

Cortical Activation ◽

Emission Tomography ◽

Functional Brain ◽

Functional Brain Mapping ◽

Positron Emission ◽

Neurosurgical Planning

Object The purpose of this report is to demonstrate the value of functional brain mapping using the positron emission tomography (PET) method for preoperative neurosurgical planning in children with brain tumors. Brain maps were used to characterize the relationship between potentially resectable tumors and functionally eloquent brain areas. Methods Five children, ranging in age from 3 to 13 years, with hemispheric brain tumors adjacent to eloquent cortex were studied. Magnetic resonance (MR) imaging was used to identify the brain tumors; PET imaging after injection of [18F]fluorodeoxyglucose (FDG), [11C]l-methionine (CMET), or a combination of the two was performed to grade the tumors; and a [15O] H2O uptake study was used to characterize the anatomical relationships of the tumors to functional cortex. The cortical activation maps were obtained during control periods and during behavioral tasks and were used to document motor, visual, and speech and language organizational areas. Wada tests were performed in two patients. Language and speech activation was concordant with the results of Wada testing. Conclusions Functional brain mapping using PET scans and coregistered MR images provided the neurosurgeon with precise definitions of structural and functional cortical areas; this altered surgical management in some cases and/or was used to predict outcome. The combination of PET imaging with FDG and/or CMET and measurements of [15O] water uptake was useful in characterizing and grading tumors and instrumental in achieving effective neurosurgical planning. Postoperative results in the five cases suggest that preoperative functional brain mapping has the potential to improve outcome by defining a surgical plan to maximize resection and minimize the risk of neurological sequelae.

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Hierarchical Density-Based Clustering of White Matter Tracts in the Human Brain

International Journal of Knowledge Discovery in Bioinformatics ◽

10.4018/jkdb.2010100101 ◽

2010 ◽

Vol 1 (4) ◽

pp. 1-25 ◽

Cited By ~ 5

Author(s):

Junming Shao ◽

Klaus Hahn ◽

Qinli Yang ◽

Afra Wohlschläeger ◽

Christian Boehm ◽

...

Keyword(s):

White Matter ◽

Human Brain ◽

Similarity Measure ◽

Multiple Scales ◽

Diffusion Tensor ◽

Clustering Algorithms ◽

Vast Number ◽

Lower Bounding ◽

Density Based Clustering ◽

Neurosurgical Planning

Diffusion tensor magnetic resonance imaging (DTI) provides a promising way of estimating the neural fiber pathways in the human brain non-invasively via white matter tractography. However, it is difficult to analyze the vast number of resulting tracts quantitatively. Automatic tract clustering would be useful for the neuroscience community, as it can contribute to accurate neurosurgical planning, tract-based analysis, or white matter atlas creation. In this paper, the authors propose a new framework for automatic white matter tract clustering using a hierarchical density-based approach. A novel fiber similarity measure based on dynamic time warping allows for an effective and efficient evaluation of fiber similarity. A lower bounding technique is used to further speed up the computation. Then the algorithm OPTICS is applied, to sort the data into a reachability plot, visualizing the clustering structure of the data. Interactive and automatic clustering algorithms are finally introduced to obtain the clusters. Extensive experiments on synthetic data and real data demonstrate the effectiveness and efficiency of our fiber similarity measure and show that the hierarchical density-based clustering method can group these tracts into meaningful bundles on multiple scales as well as eliminating noisy fibers.

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Automatic identification of atypical clinical fMRI results

Neuroradiology ◽

10.1007/s00234-020-02510-z ◽

2020 ◽

Vol 62 (12) ◽

pp. 1677-1688

Author(s):

J. Martijn Jansma ◽

Geert-Jan Rutten ◽

Lenny E. Ramsey ◽

T. J. Snijders ◽

Alberto Bizzi ◽

...

Keyword(s):

Template Matching ◽

Objective Evaluation ◽

Automatic Identification ◽

Low Grade ◽

Activation Patterns ◽

Typical Data ◽

Neurosurgical Planning ◽

Clinical Fmri ◽

Scan Data ◽

Verb Generation

Abstract Purpose Functional MRI is not routinely used for neurosurgical planning despite potential important advantages, due to difficulty of determining quality. We introduce a novel method for objective evaluation of fMRI scan quality, based on activation maps. A template matching analysis (TMA) is presented and tested on data from two clinical fMRI protocols, performed by healthy controls in seven clinical centers. Preliminary clinical utility is tested with data from low-grade glioma patients. Methods Data were collected from 42 healthy subjects from seven centers, with standardized finger tapping (FT) and verb generation (VG) tasks. Copies of these “typical” data were deliberately analyzed incorrectly to assess feasibility of identifying them as “atypical.” Analyses of the VG task administered to 32 tumor patients assessed sensitivity of the TMA method to anatomical abnormalities. Results TMA identified all atypical activity maps for both tasks, at the cost of incorrectly classifying 3.6 (VG)–6.5% (FT) of typical maps as atypical. For patients, the average TMA was significantly higher than atypical healthy scans, despite localized anatomical abnormalities caused by a tumor. Conclusion This study supports feasibility of TMA for objective identification of atypical activation patterns for motor and verb generation fMRI protocols. TMA can facilitate the use and evaluation of clinical fMRI in hospital settings that have limited access to fMRI experts. In a clinical setting, this method could be applied to automatically flag fMRI scans showing atypical activation patterns for further investigation to determine whether atypicality is caused by poor scan data quality or abnormal functional topography.

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Predicting the location of mouth motor cortex in patients with brain tumors by using somatosensory evoked field measurements

Journal of Neurosurgery ◽

10.3171/jns-07/09/0481 ◽

2007 ◽

Vol 107 (3) ◽

pp. 481-487 ◽

Cited By ~ 16

Author(s):

Heidi E. Kirsch ◽

Zhao Zhu ◽

Susanne Honma ◽

Anne Findlay ◽

Mitchel S. Berger ◽

...

Keyword(s):

Motor Cortex ◽

Somatosensory Cortex ◽

Imaging Techniques ◽

Quantitative Relationship ◽

Field Measurements ◽

Face Area ◽

Functional Regions ◽

Somatosensory Evoked Fields ◽

Neurosurgical Planning ◽

Motor Areas

Object Before resective brain surgery, localization of the functional regions is necessary to minimize postoperative deficits. The face area has been relatively difficult to map noninvasively by using functional imaging techniques. Preoperative localization of face somatosensory cortex with magnetoencephalography (MEG) may allow the surgeon to predict the location of mouth motor areas. Methods The authors compared the location of face somatosensory cortex obtained with somatosensory evoked fields during preoperative MEG with the mouth motor areas identified during intraoperative electrocortical stimulation (ECS) mapping in 13 patients undergoing resection of brain tumor. Results In this group of patients, ECS mouth motor sites were usually anterior and lateral to MEG localizations of lip somatosensory cortex. The consistent quantitative relationship between results of these two mapping procedures allows the practitioner to predict the location of mouth motor cortex based on noninvasive preoperative MEG measurements. Conclusions Based on this result, the authors suggest that somatosensory mapping using MEG can be used to guide intraoperative mapping and neurosurgical planning.

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