Intraoperative Ultrasonography in Resection of Malignant Glioma
Intraoperative Ultrasonography in Resection of Malignant Glioma
Object: The authors present their experience with coregistration of preoperative imaging data to intraoperative ultrasonography in the resection of high-grade gliomas, focusing on methodology and clinical observation.
Methods: Images were obtained preoperatively and coregistered to intraoperative hand-held ultrasound images by merging the respective imaging coordinate systems. After patient registration and imaging calibration, the authors computed the location on the magnetic resonance (MR) space of each pixel on an ultrasound image acquired in the operating room. The data were retrospectively reviewed in 11 patients with high-grade gliomas who underwent ultrasonography-assisted resection at our institution between June 2000 and December 2002.
Satisfactory coregistration of intraoperative ultrasound and preoperative MR images was accomplished in all cases. Ultrasound and MR image data were closely congruent. Preoperative setup and intraoperative use of the system were unencumbering.
Conclusions: Based on these preliminary results, intraoperative ultrasonography is an attractive neuronavigational alternative, by which a less expensive and constraining imaging technique is used to acquire updated information. Optimal intraoperative guidance can be provided by the integration of this with other imaging studies.
Modern neuronavigational technologies have a major impact on intracranial neurosurgery. Neuronavigation allows localization of the lesion, determination of its size, and determination of a safe surgical corridor by which to approach it. Different surgical navigation systems are now in use, including multiarticulated arms, optical systems, and magnetic systems, which provide different localizing techniques. All of these systems require imaging data acquired preoperatively. Intraoperative ultrasonography offers real-time data.
Coregistration of intraoperative ultrasound images is now possible using image-guided technology, and this is being implemented by a number of groups. Issues of implementation including methodology, accuracy, and evaluation of tumor remnants with high sensitivity and specificity are not well characterized.
We present our experience with coregistered ultrasound images in the resection of high-grade gliomas, with particular attention to methodology and clinical observation.
Object: The authors present their experience with coregistration of preoperative imaging data to intraoperative ultrasonography in the resection of high-grade gliomas, focusing on methodology and clinical observation.
Methods: Images were obtained preoperatively and coregistered to intraoperative hand-held ultrasound images by merging the respective imaging coordinate systems. After patient registration and imaging calibration, the authors computed the location on the magnetic resonance (MR) space of each pixel on an ultrasound image acquired in the operating room. The data were retrospectively reviewed in 11 patients with high-grade gliomas who underwent ultrasonography-assisted resection at our institution between June 2000 and December 2002.
Satisfactory coregistration of intraoperative ultrasound and preoperative MR images was accomplished in all cases. Ultrasound and MR image data were closely congruent. Preoperative setup and intraoperative use of the system were unencumbering.
Conclusions: Based on these preliminary results, intraoperative ultrasonography is an attractive neuronavigational alternative, by which a less expensive and constraining imaging technique is used to acquire updated information. Optimal intraoperative guidance can be provided by the integration of this with other imaging studies.
Modern neuronavigational technologies have a major impact on intracranial neurosurgery. Neuronavigation allows localization of the lesion, determination of its size, and determination of a safe surgical corridor by which to approach it. Different surgical navigation systems are now in use, including multiarticulated arms, optical systems, and magnetic systems, which provide different localizing techniques. All of these systems require imaging data acquired preoperatively. Intraoperative ultrasonography offers real-time data.
Coregistration of intraoperative ultrasound images is now possible using image-guided technology, and this is being implemented by a number of groups. Issues of implementation including methodology, accuracy, and evaluation of tumor remnants with high sensitivity and specificity are not well characterized.
We present our experience with coregistered ultrasound images in the resection of high-grade gliomas, with particular attention to methodology and clinical observation.
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