Brain tumor surgery with 3-dimensional surface navigation

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Journal titleNeurosurgery
Subjectarticle; brain metastasis; brain size; brain tumor; cancer surgery; cavernoma; controlled study; glioma; human; intermethod comparison; major clinical study; meningioma; nuclear magnetic resonance imaging; preoperative evaluation; priority journal; three dimensional imaging; treatment planning; Algorithms; Brain Neoplasms; Humans; Imaging, Three-Dimensional; Neuronavigation; Software
AbstractBACKGROUND:: Precise lesion localization is necessary for neurosurgical procedures not only during the operative approach, but also during the preoperative planning phase. OBJECTIVE:: To evaluate the advantages of 3-dimensional (3-D) brain surface visualization over conventional 2-dimensional (2-D) magnetic resonance images for surgical planning and intraoperative guidance in brain tumor surgery. METHODS:: Preoperative 3-D brain surface visualization was performed with neurosurgical planning software in 77 cases (58 gliomas, 7 cavernomas, 6 meningiomas, and 6 metastasis). Direct intraoperative navigation on the 3-D brain surface was additionally performed in the last 20 cases with a neurosurgical navigation system. For brain surface reconstruction, patient-specific anatomy was obtained from MR imaging and brain volume was extracted with skull stripping or watershed algorithms, respectively. Three-dimensional visualization was performed by direct volume rendering in both systems. To assess the value of 3-D brain surface visualization for topographic lesion localization, a multiple-choice test was developed. To assess accuracy and reliability of 3-D brain surface visualization for intraoperative orientation, we topographically correlated superficial vessels and gyral anatomy on 3-D brain models with intraoperative images. RESULTS:: The rate of correct lesion localization with 3-D was significantly higher (P = .001, χ), while being significantly less time consuming (P < .001, χ) compared with 2-D images. Intraoperatively, visual correlation was found between the 3-D images, superficial vessels, and gyral anatomy. CONCLUSION:: The proposed method of 3-D brain surface visualization is fast, clinically reliable for preoperative anatomic lesion localization and patient-specific planning, and, together with navigation, improves intraoperative orientation in brain tumor surgery and is relatively independent of brain shift. © 2012 by the Congress of Neurological Surgeons.
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AffiliationNational Research Council Canada (NRC-CNRC); NRC Institute for Biodiagnostics (IBD-IBD)
Peer reviewedYes
NPARC number21269476
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Record identifier13d5ae09-1234-483a-bb04-b97e874ac2b9
Record created2013-12-12
Record modified2016-05-09
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