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Jung S, Kim IY, Moon KS, Jung TY, Jang WY, Kim YJ, Lee TK, Park SJ, Lim SH. Distinct Specialized Center of Excellence, the Story of Hwasun Neurosurgery at Chonnam National University Hwasun Hospital. Brain Tumor Res Treat 2023; 11:94-102. [PMID: 37151151 PMCID: PMC10172013 DOI: 10.14791/btrt.2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/21/2023] [Indexed: 05/09/2023] Open
Abstract
The paper provides a comprehensive overview of the growth and development of Hwasun Neurosurgery at Chonnam National University Hwasun Hospital over the past 18 years. As the first brain tumor center in Korea when it was established in April 2004, Hwasun Neurosurgery has since become one of the leading institutions in brain tumor education and research in the country. Its impressive clinical and basic research capabilities, dedication to professional education, and numerous academic achievements have all contributed to its reputation as a top-tier institution. We hope this will become a useful guide for other brain tumor centers or educational institutions by sharing the story of Hwasun Neurosurgery.
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Affiliation(s)
- Shin Jung
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea.
| | - In-Young Kim
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Kyung-Sub Moon
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Tae-Young Jung
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Woo-Youl Jang
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Yeong Jin Kim
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Tae-Kyu Lee
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Sue Jee Park
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Sa-Hoe Lim
- Department of Neurosurgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea
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Habib A, Jovanovich N, Hoppe M, Hameed NF, Edwards L, Zinn P. Navigated 3D ultrasound-guided resection of high-grade gliomas: A case series and review. Surg Neurol Int 2022; 13:356. [PMID: 36128115 PMCID: PMC9479605 DOI: 10.25259/sni_469_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background: The crux in high-grade glioma surgery remains maximizing resection without affecting eloquent brain areas. Toward this, a myriad of adjunct tools and techniques has been employed to enhance surgical safety and efficacy. Despite intraoperative MRI and advanced neuronavigational techniques, as well as augmented reality, to date, the only true real-time visualization tool remains the ultrasound (US). Neuroultrasonography is a cost-efficient imaging modality that offers instant, real-time information about the changing anatomical landscape intraoperatively. Recent advances in technology now allow for the integration of intraoperative US with neuronavigation. Case Description: In this report, we present the resection technique for three cases of high-grade gliomas (two glioblastomas and one anaplastic astrocytoma). The patient presented with a variable clinical spectrum. All three cases have been performed using the Brainlab® neuronavigation system (BrainLAB, Munich, Germany) and the bk5000 US Machine® (BK Medical, Analogic Corporation, Peabody, Massachusetts, USA). Conclusion: Gross total resection was achieved in all three cases. The use of 3D navigated US was a reliable adjunct surgical tool in achieving favorable resection outcomes in these patients.
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Chen YW, Hanak BW, Yang TC, Wilson TA, Hsia JM, Walsh HE, Shih HC, Nagatomo KJ. Computer-assisted surgery in medical and dental applications. Expert Rev Med Devices 2021; 18:669-696. [PMID: 33539198 DOI: 10.1080/17434440.2021.1886075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Computer-assisted surgery (CAS) is a broad surgical methodology that utilizes computer technology to both plan and execute surgical intervention. CAS is widespread in both medicine and dentistry as it allows for minimally invasive and precise surgical procedures. Key innovations in volumetric imaging, virtual surgical planning software, instrument tracking, and robotics have assisted in facilitating the transfer of surgical plans to precise execution of surgical procedures. CAS has long been used in certain medical specialties including neurosurgery, cardiology, orthopedic surgery, otolaryngology, and interventional radiology, and has since expanded to oral and maxillofacial application, particularly for computer-assisted implant surgery. AREAS COVERED This review provides an updated overview of the most current research for CAS in medicine and dentistry, with a focus on neurosurgery and dental implant surgery. The MEDLINE electronic database was searched and relevant original and review articles from 2005 to 2020 were included. EXPERT OPINION Recent literature suggests that CAS performs favorably in both neurosurgical and dental implant applications. Computer-guided surgical navigation is well entrenched as standard of care in neurosurgery. Whereas static computer-assisted implant surgery has become established in dentistry, dynamic computer-assisted navigation is newly poised to trend upward in dental implant surgery.
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Affiliation(s)
- Yen-Wei Chen
- Department of Restorative Dentistry, University of Washington School of Dentistry Seattle,98195, WA, USA
| | - Brian W Hanak
- Department of Neurosurgery, Loma Linda University Health Loma Linda, 92354, CA, USA
| | - Tzu-Chian Yang
- Department of Restorative Dentistry, University of Washington School of Dentistry Seattle,98195, WA, USA
| | - Taylor A Wilson
- Department of Neurosurgery, Loma Linda University Health Loma Linda, 92354, CA, USA
| | - Jenovie M Hsia
- Department of Restorative Dentistry, University of Washington School of Dentistry Seattle,98195, WA, USA
| | - Hollie E Walsh
- Department of Restorative Dentistry, University of Washington School of Dentistry Seattle,98195, WA, USA
| | - Huai-Che Shih
- Department of Restorative Dentistry, University of Washington School of Dentistry Seattle,98195, WA, USA
| | - Kanako J Nagatomo
- Department of Periodontics, University of Washington School of Dentistry Seattle,98195 WA,USA
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Moiraghi A, Prada F, Delaidelli A, Guatta R, May A, Bartoli A, Saini M, Perin A, Wälchli T, Momjian S, Bijlenga P, Schaller K, DiMeco F. Navigated Intraoperative 2-Dimensional Ultrasound in High-Grade Glioma Surgery: Impact on Extent of Resection and Patient Outcome. Oper Neurosurg (Hagerstown) 2021; 18:363-373. [PMID: 31435672 DOI: 10.1093/ons/opz203] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/16/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Maximizing extent of resection (EOR) and reducing residual tumor volume (RTV) while preserving neurological functions is the main goal in the surgical treatment of gliomas. Navigated intraoperative ultrasound (N-ioUS) combining the advantages of ultrasound and conventional neuronavigation (NN) allows for overcoming the limitations of the latter. OBJECTIVE To evaluate the impact of real-time NN combining ioUS and preoperative magnetic resonance imaging (MRI) on maximizing EOR in glioma surgery compared to standard NN. METHODS We retrospectively reviewed a series of 60 cases operated on for supratentorial gliomas: 31 operated under the guidance of N-ioUS and 29 resected with standard NN. Age, location of the tumor, pre- and postoperative Karnofsky Performance Status (KPS), EOR, RTV, and, if any, postoperative complications were evaluated. RESULTS The rate of gross total resection (GTR) in NN group was 44.8% vs 61.2% in N-ioUS group. The rate of RTV > 1 cm3 for glioblastomas was significantly lower for the N-ioUS group (P < .01). In 13/31 (42%), RTV was detected at the end of surgery with N-ioUS. In 8 of 13 cases, (25.8% of the cohort) surgeons continued with the operation until complete resection. Specificity was greater in N-ioUS (42% vs 31%) and negative predictive value (73% vs 54%). At discharge, the difference between pre- and postoperative KPS was significantly higher for the N-ioUS (P < .01). CONCLUSION The use of an N-ioUS-based real-time has been beneficial for resection in noneloquent high-grade glioma in terms of both EOR and neurological outcome, compared to standard NN. N-ioUS has proven usefulness in detecting RTV > 1 cm3.
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Affiliation(s)
- Alessandro Moiraghi
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Francesco Prada
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "C. Besta," Milan, Italy.,Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, Virginia.,Focused Ultrasound Foundation, Charlottesville, Virginia
| | - Alberto Delaidelli
- Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Ramona Guatta
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Adrien May
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Andrea Bartoli
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marco Saini
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "C. Besta," Milan, Italy
| | - Alessandro Perin
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "C. Besta," Milan, Italy
| | - Thomas Wälchli
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.,Group of CNS Angiogenesis and Neurovascular Link, Physician-Scientist Program, Institute for Regenerative Medicine, Neuroscience Center Zurich, University Hospital Zurich, Zurich, Switzerland.,Division of Neurosurgery, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH), University Hospital Zurich, Zurich, Switzerland.,Department of Fundamental Neurobiology, Krembil Research Institute, University of Toronto, Toronto, Canada.,Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Canada
| | - Shahan Momjian
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Bijlenga
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Karl Schaller
- Division of Neurosurgery, University of Geneva Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico "C. Besta," Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, Maryland
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Abstract
In neurosurgery, the extent of resection plays a critical role, especially in the management of malignant gliomas. These tumors are characterized through a diffuse infiltration into the surrounding brain parenchyma. Delineation between tumor and normal brain parenchyma can therefore often be challenging. During the recent years, several techniques, aiming at better intraoperative tumor visualization, have been developed and implemented in the field of brain tumor surgery. In this chapter, we discuss current strategies for intraoperative imaging in brain tumor surgery, comprising conventional techniques such as neuronavigation, techniques using fluorescence-guided surgery, and further highly precise developments such as targeted fluorescence spectroscopy or Raman spectroscopy.
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Affiliation(s)
- Stephanie Schipmann-Miletić
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany
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Hendrix P, Senger S, Griessenauer CJ, Simgen A, Linsler S, Oertel J. Preoperative navigated transcranial magnetic stimulation and tractography in transparietal approach to the trigone of the lateral ventricle. J Clin Neurosci 2017; 41:154-161. [DOI: 10.1016/j.jocn.2017.02.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/10/2017] [Indexed: 11/26/2022]
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SIMULATION USING REGRESSION ANALYSIS OF MIDDLE CRANIAL FOSSA IN BOYS AND GIRLS OF VARIOUS CRANIOTYPES. WORLD OF MEDICINE AND BIOLOGY 2017. [DOI: 10.26724/2079-8334-2017-3-61-17-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gerard IJ, Kersten-Oertel M, Petrecca K, Sirhan D, Hall JA, Collins DL. Brain shift in neuronavigation of brain tumors: A review. Med Image Anal 2016; 35:403-420. [PMID: 27585837 DOI: 10.1016/j.media.2016.08.007] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Neuronavigation based on preoperative imaging data is a ubiquitous tool for image guidance in neurosurgery. However, it is rendered unreliable when brain shift invalidates the patient-to-image registration. Many investigators have tried to explain, quantify, and compensate for this phenomenon to allow extended use of neuronavigation systems for the duration of surgery. The purpose of this paper is to present an overview of the work that has been done investigating brain shift. METHODS A review of the literature dealing with the explanation, quantification and compensation of brain shift is presented. The review is based on a systematic search using relevant keywords and phrases in PubMed. The review is organized based on a developed taxonomy that classifies brain shift as occurring due to physical, surgical or biological factors. RESULTS This paper gives an overview of the work investigating, quantifying, and compensating for brain shift in neuronavigation while describing the successes, setbacks, and additional needs in the field. An analysis of the literature demonstrates a high variability in the methods used to quantify brain shift as well as a wide range in the measured magnitude of the brain shift, depending on the specifics of the intervention. The analysis indicates the need for additional research to be done in quantifying independent effects of brain shift in order for some of the state of the art compensation methods to become useful. CONCLUSION This review allows for a thorough understanding of the work investigating brain shift and introduces the needs for future avenues of investigation of the phenomenon.
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Affiliation(s)
- Ian J Gerard
- McConnell Brain Imaging Center, MNI, McGill University, Montreal, Canada.
| | | | - Kevin Petrecca
- Department of Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Denis Sirhan
- Department of Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Jeffery A Hall
- Department of Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, MNI, McGill University, Montreal, Canada; Department of Neurosurgery, McGill University, Montreal, Quebec, Canada
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Prada F, Del Bene M, Mattei L, Casali C, Filippini A, Legnani F, Mangraviti A, Saladino A, Perin A, Richetta C, Vetrano I, Moiraghi A, Saini M, DiMeco F. Fusion imaging for intra-operative ultrasound-based navigation in neurosurgery. J Ultrasound 2014; 17:243-51. [PMID: 25177400 DOI: 10.1007/s40477-014-0111-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 06/02/2014] [Indexed: 12/19/2022] Open
Abstract
The major shortcoming of image-guided navigation systems is the use of presurgically acquired image data, which does not account for intra-operative changes such as brain shift, tissue deformation and tissue removal occurring during the surgical procedure. Intra-operative ultrasound (iUS) is becoming widely used in neurosurgery but they lack orientation and panoramic view. In this article, we describe our procedure for US-based real-time neuro-navigation during surgery. We used fusion imaging between preoperative magnetic resonance imaging (MRI) and iUS for brain lesion removal in 67 patients so far. Surgical planning is based on preoperative MRI only. iUS images obtained during surgery are fused with the preoperative MRI. Surgery is performed under intra-operative US control. Relying on US imaging, it is possible to recalibrate navigated MRI imaging, adjusting distortion due to brain shift and tissue resection, continuously updating the two modalities. Ultrasound imaging provides excellent visualization of targets, their margins and surrounding structures. The use of navigated MRI is helpful in better understanding cerebral ultrasound images, providing orientation and panoramic view. Intraoperative US-guided neuro-navigation adjustments are very accurate and helpful in the event of brain shift. The use of this integrated system allows for a true real-time feedback during surgery.
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Affiliation(s)
- Francesco Prada
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy
| | - Massimiliano Del Bene
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy ; Università degli Studi di Milano, Milan, Italy
| | - Luca Mattei
- Università degli Studi di Milano, Milan, Italy
| | - Cecilia Casali
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy
| | - Assunta Filippini
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy ; Università degli Studi di Milano, Milan, Italy
| | - Federico Legnani
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy
| | | | - Andrea Saladino
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy
| | - Alessandro Perin
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy
| | - Carla Richetta
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy ; Università degli Studi di Milano, Milan, Italy
| | - Ignazio Vetrano
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy ; Università degli Studi di Milano, Milan, Italy
| | - Alessandro Moiraghi
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy ; Università degli Studi di Milano, Milan, Italy
| | - Marco Saini
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", via Celoria 11, 20133 Milan, Italy ; Department of Neurosurgery, Johns Hopkins University, Baltimore, USA
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Shinoda J, Yokoyama K, Miwa K, Ito T, Asano Y, Yonezawa S, Yano H. Epilepsy surgery of dysembryoplastic neuroepithelial tumors using advanced multitechnologies with combined neuroimaging and electrophysiological examinations. EPILEPSY & BEHAVIOR CASE REPORTS 2013; 1:97-105. [PMID: 25667839 PMCID: PMC4150595 DOI: 10.1016/j.ebcr.2013.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 11/26/2022]
Abstract
Purpose We report three cases of dysembryoplastic neuroepithelial tumor (DNT) with intractable epilepsy which were successfully treated with surgery. Methods In all cases, technology beyond the routine workup was critical to success. Preoperative magnetic resonance imaging, 18F-fluorodeoxyglucose positron emission tomography (PET), 11C-methionine-PET, interictal electroencephalography, and intraoperative electrocorticography were utilized in all patients. In individual cases, however, additional procedures such as preoperative magnetoencephalography (Case 1), diffusion tensor fiber tractography, a neuronavigation system, and intraoperative somatosensory-evoked potential (Case 2), and fiber tractography and the neuronavigation-guided fence-post tube technique (Case 3) were instrumental. Results In all the cases, the objectives of total tumor resection, resection of the epileptogenic zone, and complete postoperative seizure control and the avoidance of surgical complications were achieved. Conclusions Dysembryoplastic neuroepithelial tumor is commonly associated with medically intractable epilepsy, and surgery is frequently utilized. As DNT may arise in any supratentorial and intracortical locations within or near the critical area of the brain, meticulous surgical strategies are necessary to avoid neurological deficits. We demonstrate in the following three cases how adjunct procedures using advanced multitechnologies with neuroimaging and electrophysiological examinations may be utilized to ensure success in DNT surgery.
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Affiliation(s)
- Jun Shinoda
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan
| | - Kazutoshi Yokoyama
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan
| | - Kazuhiro Miwa
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan
| | - Takeshi Ito
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan
| | - Yoshitaka Asano
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan
| | - Shingo Yonezawa
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction and Section of Neurosurgery, Kizawa Memorial Hospital, Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Japan
| | - Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Japan
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Abstract
INTRODUCTION "Navigation in surgery" spans a broad area, which, depending on the clinical challenge, can have different meanings. Over the past decade, navigation in surgery has evolved beyond imaging modalities and bulky systems into the rich networking of the cloud or devices that are pocket-sized. DISCUSSION This article will review various aspects of navigation in the operating room and beyond. This includes a short history of navigation, the evolution of surgical navigation, as well as technical aspects and clinical benefits with examples from neurosurgery, spinal surgery, and orthopedics. CONCLUSION With improved computer technology and a trend towards advanced information processing within hospitals, navigation is quickly becoming an integral part in the surgical routine of clinicians.
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Stereotactic Percutaneous Cryoablation for Renal Tumors: Initial Clinical Experience. J Urol 2010; 183:884-8. [DOI: 10.1016/j.juro.2009.11.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Indexed: 11/17/2022]
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YAMADA SM, MASAHIRA N, IKAWA N, NAKAI E, PARK KC, SHIMIZU K. Preoperative Surgical Approach Planning for Metastatic Pituitary Stalk Tumor Using Multimodal Fusion Imaging in a Neuronavigation System -Case Report-. Neurol Med Chir (Tokyo) 2010; 50:259-63. [DOI: 10.2176/nmc.50.259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Naoki IKAWA
- Department of Neurosurgery, Kochi Medical School, Kochi University
| | - Eiichi NAKAI
- Department of Neurosurgery, Kochi Medical School, Kochi University
| | - Kae Chang PARK
- Department of Neurosurgery, Kochi Medical School, Kochi University
| | - Keiji SHIMIZU
- Department of Neurosurgery, Kochi Medical School, Kochi University
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Upadhyay UM, Golby AJ. Role of pre- and intraoperative imaging and neuronavigation in neurosurgery. Expert Rev Med Devices 2009; 5:65-73. [PMID: 18095898 DOI: 10.1586/17434440.5.1.65] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Advances in neuroimaging acquisition, computing and image processing have enabled neurosurgeons to use radiological imaging to guide both preoperative planning and intraoperative guidance. In preoperative planning, imaging may be used to evaluate surgical risks, choose the best method of intervention and select the safest surgical approach. Neuronavigation may be useful in designing the surgical flap and alerting the surgeon of surrounding anatomy. Finally, intraoperative imaging may be used to define brain shift associated with the resection of intracranial lesions, assist in more complete lesion resection, and monitor for certain intraoperative complications. In the following review, we briefly examine the history of neuroradiology for neurosurgery, neuronavigation and intraoperative imaging and trace their advances to current systems in use. We will also highlight new experimental applications of neuroimaging that are currently being refined.
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Affiliation(s)
- Urvashi M Upadhyay
- Department of Neurosurgery, Boston Children's Hospital and Brigham and Women's Hospital, Boston, MA 02115, USA.
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Abstract
The purpose of this chapter is to provide an introduction to magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of human brain tumors, including the primary applications and basic terminology involved. Readers who wish to know more about this broad subject should seek out the referenced books (1. Tofts (2003) Quantitative MRI of the brain. Measuring changes caused by disease. Wiley; Bradley and Stark (1999) 2. Magnetic resonance imaging, 3rd Edition. Mosby Inc; Brown and Semelka (2003) 3. MRI basic principles and applications, 3rd Edition. Wiley-Liss) or reviews (4. Top Magn Reson Imaging 17:127-36, 2006; 5. JMRI 24:709-724, 2006; 6. Am J Neuroradiol 27:1404-1411, 2006).MRI is the most popular means of diagnosing human brain tumors. The inherent difference in the magnetic resonance (MR) properties of water between normal tissues and tumors results in contrast differences on the image that provide the basis for distinguishing tumors from normal tissues. In contrast to MRI, which provides spatial maps or images using water signals of the tissues, proton MRS detects signals of tissue metabolites. MRS can complement MRI because the observed MRS peaks can be linked to inherent differences in biochemical profiles between normal tissues and tumors.The goal of MRI and MRS is to characterize brain tumors, including tumor core, edge, edema, volume, types, and grade. The commonly used brain tumor MRI protocol includes T2-weighted images and T1-weighted images taken both before and after the injection of a contrast agent (typically gadolinium: Gd). The commonly used MRS technique is either point-resolved spectroscopy (PRESS) or stimulated echo acquisition mode (STEAM).
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Moche M, Trampel R, Kahn T, Busse H. Navigation concepts for MR image-guided interventions. J Magn Reson Imaging 2008; 27:276-91. [DOI: 10.1002/jmri.21262] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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