Image-guided neurosurgery with intraoperative MRI: Update of frameless stereotaxy and radicality control

被引:62
作者
Wirtz, CR
Tronnier, VM
Bonsanto, MM
Knauth, M
Staubert, A
Albert, FK
Kunze, S
机构
[1] Univ Heidelberg, Dept Neurol Surg, Heidelberg, Germany
[2] Univ Heidelberg, Dept Neuroradiol, Heidelberg, Germany
关键词
Intraoperative magnetic resonance imaging (MRI); neuronavigation; image-guided neurosurgery; frameless stereotaxy; instrumentation; intraoperative imaging;
D O I
10.1159/000099900
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Intraoperative shifts and resulting inaccuracies have been a concern in frame-based and frameless stereotactically guided interventions, particularly in open microsurgical procedures. Trying to solve this problem, we developed a method to perform intraoperative MRI (0.2 tesla, Magnetom Open) and use intraoperatively acquired data sets to update neuronavigation. In 21 patients, intraoperative images could be used to reference navigation (mean accuracy of 0.83 +/- 0.31 mm), The operation was continued in 10 cases to resect detected tumor remnants using navigation, leaving 4 patients (19%) with residual tumor postoperatively. We showed that update of frameless stereotaxy to compensate for brain shift is feasible and might increase the number of cases where radiologically complete resection can be achieved.
引用
收藏
页码:39 / 43
页数:5
相关论文
共 14 条
[1]   EARLY POSTOPERATIVE MAGNETIC-RESONANCE-IMAGING AFTER RESECTION OF MALIGNANT GLIOMA - OBJECTIVE EVALUATION OF RESIDUAL TUMOR AND ITS INFLUENCE ON REGROWTH AND PROGNOSIS [J].
ALBERT, FK ;
FORSTING, M ;
SARTOR, K ;
ADAMS, HP ;
WILSON, CB ;
KUNZE, S ;
SALCMAN, M .
NEUROSURGERY, 1994, 34 (01) :45-61
[2]   High-grade astrocytomas in children: Radiologically complete resection is associated with an excellent long-term prognosis [J].
Campbell, JW ;
Pollack, IF ;
Martinez, AJ ;
Shultz, B .
NEUROSURGERY, 1996, 38 (02) :258-264
[3]   STEREOTAXIC RESECTION AND ITS LIMITATIONS IN GLIAL NEOPLASMS [J].
KELLY, PJ .
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 1992, 59 (1-4) :84-91
[4]   IMAGING-BASED STEREOTAXIC SERIAL BIOPSIES IN UNTREATED INTRACRANIAL GLIAL NEOPLASMS [J].
KELLY, PJ ;
DAUMASDUPORT, C ;
KISPERT, DB ;
KALL, BA ;
SCHEITHAUER, BW ;
ILLIG, JJ .
JOURNAL OF NEUROSURGERY, 1987, 66 (06) :865-874
[5]  
KREMSER C, 1995, P SOC MAGN RESON, P1163
[6]  
LUNSFORD LD, 1984, NEUROSURGERY, V15, P559
[7]  
Moriarty TM, 1996, NEUROSURG CLIN N AM, V7, P323
[8]   A FRAMELESS STEREOTAXIC INTEGRATION OF COMPUTERIZED TOMOGRAPHIC IMAGING AND THE OPERATING MICROSCOPE [J].
ROBERTS, DW ;
STROHBEHN, JW ;
HATCH, JF ;
MURRAY, W ;
KETTENBERGER, H .
JOURNAL OF NEUROSURGERY, 1986, 65 (04) :545-549
[9]  
STAUBERT A, 1997, P SMR VANC CAN, P1942
[10]   FRAMELESS STEREOTAXIC ULTRASONOGRAPHY - METHOD AND APPLICATIONS [J].
TROBAUGH, JW ;
RICHARD, WD ;
SMITH, KR ;
BUCHOLZ, RD .
COMPUTERIZED MEDICAL IMAGING AND GRAPHICS, 1994, 18 (04) :235-246