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Haegelen C, Lalys F, Jannin P, Abadie A, Collins L, Brassier G, Morandi X. Validation de la segmentation des ganglions de la base sur un template IRM 3 Tesla. Neurochirurgie 2010. [DOI: 10.1016/j.neuchi.2010.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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102
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Grunert R, Korb W, Jannin P, Dengl M, Möckel H, Neumuth T, Strauss G, Trantakis C, Meixensberger J. Systematic user-based assessment of "Navigated Control Spine" / Systematische, nutzerzentrierte Evaluation von "Navigated Control Spine". BIOMED ENG-BIOMED TE 2010; 55:351-9. [PMID: 20958097 DOI: 10.1515/bmt.2010.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was the systematic preclinical assessment of a new mill for spinal surgery. This mill automatically switches off at predefined workspace margins. The system is called the "Navigated Control Spine". The workspace is planned intraoperatively with fluoroscopic images. Assessment was performed in a simulated surgical scenario with real surgical instruments and equipment, and the following criteria were measured: "milling accuracy" and "surgical workflow parameters". To simulate the patient, an anatomical spine model was created with a Rapid Prototyping machine. The models included electronic components that simulate injuries to the structures at risk. For the workflow parameters, the results show differences between experienced and inexperienced surgeons. The maximum accuracy for experienced surgeons was +0.31 mm and for inexperienced surgeons +0.57 mm. The dura, as one of the structures at risk, was never injured.
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103
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de Guibert C, Maumet C, Ferré JC, Jannin P, Biraben A, Allaire C, Barillot C, Le Rumeur E. FMRI language mapping in children: a panel of language tasks using visual and auditory stimulation without reading or metalinguistic requirements. Neuroimage 2010; 51:897-909. [PMID: 20188187 DOI: 10.1016/j.neuroimage.2010.02.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 01/21/2010] [Accepted: 02/16/2010] [Indexed: 10/19/2022] Open
Abstract
In the context of presurgical mapping or investigation of neurological and developmental disorders in children, language fMRI raises the issue of the design of a tasks panel achievable by young disordered children. Most language tasks shown to be efficient with healthy children require metalinguistic or reading abilities, therefore adding attentional, cognitive and academic constraints that may be problematic in this context. This study experimented a panel of four language tasks that did not require high attentional skills, reading, or metalinguistic abilities. Two reference tasks involving auditory stimulation (words generation from category, "category"; auditory responsive naming, "definition") were compared with two new tasks involving visual stimulation. These later were designed to tap spontaneous phonological production, in which the names of pictures to be named involve a phonological difference (e.g. in French poule/boule/moule; "phon-diff") or change of segmentation (e.g. in French car/car-te/car-t-on; "phon-seg"). Eighteen healthy children participated (mean age: 12.7+/-3 years). Data processing involved normalizing the data via a matched pairs pediatric template, and inter-task and region of interest analyses with laterality assessment. The reference tasks predominantly activated the left frontal and temporal core language regions, respectively. The new tasks activated these two regions simultaneously, more strongly for the phon-seg task. The union and intersection of all tasks provided more sensitive or specific maps. The study demonstrates that both reference and new tasks highlight core language regions in children, and that the latter are useful for the mapping of spontaneous phonological processing. The use of several different tasks may improve the sensitivity and specificity of fMRI.
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Affiliation(s)
- Clément de Guibert
- INSERM, U746, Faculty of Medicine, CS 34317, F-35043 Rennes Cedex, France.
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104
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Jannin P, Fleig OJ, Seigneuret E, Grova C, Morandi X, Scarabin JM. A Data Fusion Environment for Multimodal and Multi-Informational Neuronavigation. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929080009148866] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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105
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Lalys F, Riffaud L, Morandi X, Jannin P. Automatic Phases Recognition in Pituitary Surgeries by Microscope Images Classification. Information Processing in Computer-Assisted Interventions 2010. [DOI: 10.1007/978-3-642-13711-2_4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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106
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Henaux PL, Hellier P, Jannin P, Coupé P, Haegelen C, Diabira S, Morandi X. Évaluation de la précision d’une méthode de recalage automatique échographie 3D intraopératoire – IRM préopératoire en neurochirurgie. Neurochirurgie 2009. [DOI: 10.1016/j.neuchi.2009.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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107
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Riffaud L, Neumuth T, Morandi X, Trantakis C, Meixensberger J, Burgert O, Trelhu B, Jannin P. Enregistrement de procédures chirurgicales : étude comparant l’activité gestuelle de neurochirurgiens seniors et juniors au cours de procédures d’exérèse de hernies discales lombaires. Neurochirurgie 2009. [DOI: 10.1016/j.neuchi.2009.08.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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108
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Lalys F, Haegelen C, Ferre JC, El-Ganaoui O, Jannin P. Construction and assessment of a 3-T MRI brain template. Neuroimage 2009; 49:345-54. [PMID: 19682582 DOI: 10.1016/j.neuroimage.2009.08.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 07/15/2009] [Accepted: 08/05/2009] [Indexed: 10/20/2022] Open
Abstract
New MR imaging protocols enable visualization of brain structures. However, for dedicated clinical applications such as targeting deep brain stimulation (DBS), a more accurate localization requires the use of atlases. We developed a three-dimensional digitized mono-subject anatomical template of the human brain based on 3-T magnetic resonance images (MRI). By averaging 15 registered T1 image acquisitions, we have shown that the final image corresponds to an optimal image, limited by the performance of the 3-T MR machine. We compared different preprocessing workflows for template construction. With the optimal strategy, along with validated existing processing methods, one T1 template and one T1-T2 mixing template were created in order to improve visualization of spatially complex deep structures. Reduction of voxel size to 0.25 mm(3) was also advantageous to observe fine structures and white matter/gray matter intensity crossings. Results demonstrated that such a template also improved inter-patient registration for population comparison in DBS. These MR templates are made freely available to our community (http://www.vmip.org/mritemplate) to serve as a reference for neuroimage processing methods.
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Affiliation(s)
- Florent Lalys
- INSERM U746, Faculté de Médecine CS 34317, Rennes Cedex, France
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109
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Paul P, Morandi X, Jannin P. A surface registration method for quantification of intraoperative brain deformations in image-guided neurosurgery. ACTA ACUST UNITED AC 2009; 13:976-83. [PMID: 19546046 DOI: 10.1109/titb.2009.2025373] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Intraoperative brain deformations decrease accuracy in image-guided neurosurgery. Approaches to quantify these deformations based on 3-D reconstruction of cortectomy surfaces have been described and have shown promising results regarding the extrapolation to the whole brain volume using additional prior knowledge or sparse volume modalities. Quantification of brain deformations from surface measurement requires the registration of surfaces at different times along the surgical procedure, with different challenges according to the patient and surgical step. In this paper, we propose a new flexible surface registration approach for any textured point cloud computed by stereoscopic or laser range approach. This method includes three terms: the first term is related to image intensities, the second to Euclidean distance, and the third to anatomical landmarks automatically extracted and continuously tracked in the 2-D video flow. Performance evaluation was performed on both phantom and clinical cases. The global method, including textured point cloud reconstruction, had accuracy within 2 mm, which is the usual rigid registration error of neuronavigation systems before deformations. Its main advantage is to consider all the available data, including the microscope video flow with higher temporal resolution than previously published methods.
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Affiliation(s)
- Perrine Paul
- Institut National de la Santé et de la Recherche Médicale (INSERM), U746, Rennes F-35042, France.
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110
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Morineau T, Morandi X, Le Moëllic N, Diabira S, Riffaud L, Haegelen C, Hénaux PL, Jannin P. Decision making during preoperative surgical planning. Hum Factors 2009; 51:67-77. [PMID: 19634310 DOI: 10.1177/0018720809332847] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This study analyzes decision making during preoperative surgical planning through two cognitive indicators: conflict and cognitive control. BACKGROUND Planning is a critical stage in naturalistic decision making, and there is some evidence suggesting that this activity depends on the level of expertise and the demands of the task. The specificity of surgery resides in the necessity to cope with (potential) conflicts between the purpose of the surgical intervention and the biological laws governing the patient's body. METHOD Six neurosurgeons (two board-certified neurosurgeons, two chief residents, and two residents) described the operative procedure envisaged on nine surgical cases of increasing surgical complexity. A detailed analysis of one surgical case described by one expert was performed. Moreover, we measured the number of conflicts and controls reported by each surgeon. RESULTS Two experts were the only ones for which the report of conflicts increased with surgical complexity (respectively, 75% and 73% of the conflict variance predicted by complexity). The two experts significantly activated a higher proportion of knowledge-based control (respectively, 43% and 38%) than did intermediates and residents. The residents significantly activated more motor skill-based controls (respectively, 40% and 44%) than did intermediates and experts. CONCLUSION It seems that expert surgical decision making to cope with task demands is significantly associated with conflict monitoring. Knowledge-based control to regulate conflict is mainly produced by experts. APPLICATION Conflicts and controls analyzed through verbal reports can be used as relevant indicators to highlight critical moments in decision making that potentially require assistance from information systems.
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111
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Neumuth T, Jannin P, Strauss G, Meixensberger J, Burgert O. Validation of knowledge acquisition for surgical process models. J Am Med Inform Assoc 2009; 16:72-80. [PMID: 18952942 PMCID: PMC2605601 DOI: 10.1197/jamia.m2748] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Accepted: 09/24/2008] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Surgical Process Models (SPMs) are models of surgical interventions. The objectives of this study are to validate acquisition methods for Surgical Process Models and to assess the performance of different observer populations. DESIGN The study examined 180 SPM of simulated Functional Endoscopic Sinus Surgeries (FESS), recorded with observation software. About 150,000 single measurements in total were analyzed. MEASUREMENTS Validation metrics were used for assessing the granularity, content accuracy, and temporal accuracy of structures of SPMs. RESULTS Differences between live observations and video observations are not statistically significant. Observations performed by subjects with medical backgrounds gave better results than observations performed by subjects with technical backgrounds. Granularity was reconstructed correctly by 90%, content by 91%, and the mean temporal accuracy was 1.8 s. CONCLUSION The study shows the validity of video as well as live observations for modeling Surgical Process Models. For routine use, the authors recommend live observations due to their flexibility and effectiveness. If high precision is needed or the SPM parameters are altered during the study, video observations are the preferable approach.
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Affiliation(s)
- Thomas Neumuth
- University of Leipzig, Innovation Center Computer Assisted Surgery, Semmelweisstr. 14, D-04103 Leipzig, Germany.
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112
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Grunert R, Strauss G, Moeckel H, Hofer M, Poessneck A, Fickweiler U, Thalheim M, Schmiedel R, Jannin P, Schulz T, Oeken J, Dietz A, Korb W. ElePhant--an anatomical electronic phantom as simulation-system for otologic surgery. Conf Proc IEEE Eng Med Biol Soc 2008; 2006:4408-11. [PMID: 17945837 DOI: 10.1109/iembs.2006.260542] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper describes the ElePhant (Electronic Phantom)-an anatomical correct simulation system based on 3D rapid prototyping models for the otologic intervention "Mastoidectomy". The anatomical structures of the head are created with plaster as base material using 3D-printing as rapid prototyping technology (RPT). Structures at risk, represented by electrically conductible material and fiber optics, are realized as an electric circuit and can be detected during the simulation of the surgical procedure. An accuracy study of 15 identical RPT-models compared to the 3D reconstructed CT-dataset of the patient showed that the mean accuracy is lower than the reconstructed CT layer thickness of 0.5 mm. An evaluation study of the ElePhant-system for "Mastoidectomy" was performed by 7 ENT-surgeons. The mean value of the study questionnaire (evaluation range from -2 (not at all) to +2 (very good)) was +1.2. The results showed that the ElePhant can simulate "Mastoidectomy" realistically. It is especially suitable for the simulation of the correct representation and position of the anatomical structures, realistic operation setting, and realistic milling properties of the bone structure. Furthermore it is applicable for training of surgeons.
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Affiliation(s)
- R Grunert
- Innovation Center Comput. Assisted Surg. (ICCAS), Leipzig Univ., Germany
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113
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Abstract
BACKGROUND In the Internet-able era, reviewers are faced with an increased number of manuscripts and decreased time to review. In order to maintain the same, if not higher level of quality in the peer-review process, a net gain in productivity is required. Our goal is to present a manuscript peer-review checklist to help reviewers achieve this secondary yet critical task in a more systematic fashion. METHODS To this end, we have compiled, structured and processed information from six reference standards and guidelines as well as directives from 21 peer-reviewed journals and conferences, resulting in a 71 criteria checklist. We ensured that criteria were assessable based on the verification, validation and evaluation paradigm. RESULTS The checklist is presented in the manuscript, along with a description of a review workflow. FINDINGS It is hoped that the checklist will be widely disseminated, and we are looking for feedback on validation and improvements in order to perform a quantitative study on productivity gains using this tool.
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Affiliation(s)
- Simon Duchesne
- Département de Radiologie, Faculté de Médecine, et Centre de Recherche de l'Université Laval Robert Giffard, Université Laval, Québec, Canada.
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114
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Abstract
In this paper, we outline a way to improve computer-assisted neurosurgery using surgical models along with patient-specific models built from multimodal images. We propose a methodological framework for surgical models that include the definition of a surgical ontology, the development of software for describing surgical procedures based on this ontology and the analysis of these descriptions to generate knowledge about surgical practice. Knowledge generation is illustrated by two studies. One hundred fifty-nine patients who underwent brain tumor surgery were described from postoperative reports using the surgical ontology. First, from a subset of 106 surgical cases, we computed a decision tree using a prediction approach that gave probability in terms of operating room patient positioning percentages and according to tumor location within one or more lobes. Second, from the whole set of 159 surgical cases, we identified 6 clusters describing families of cases according to pathology-related parameters. Results from both studies showed possible prediction of parts of the surgical procedure from pathology-related characteristics of the patient. Surgical models enable surgical knowledge to be made explicit, facilitating the surgical decision-making process and surgical planning and improving the human-computer interface during surgery.
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Affiliation(s)
- P Jannin
- INSERM, U746, Faculté de Médecine CS 34317, F-35043 Rennes Cedex, France.
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115
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116
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Jannin P, Grova C, Maurer CR. Model for defining and reporting reference-based validation protocols in medical image processing. Int J Comput Assist Radiol Surg 2006. [DOI: 10.1007/s11548-006-0044-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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117
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Paul P, Fleig O, Jannin P. Augmented virtuality based on stereoscopic reconstruction in multimodal image-guided neurosurgery: methods and performance evaluation. IEEE Trans Med Imaging 2005; 24:1500-11. [PMID: 16279086 DOI: 10.1109/tmi.2005.857029] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Displaying anatomical and physiological information derived from preoperative medical images in the operating room is critical in image-guided neurosurgery. This paper presents a new approach referred to as augmented virtuality (AV) for displaying intraoperative views of the operative field over three-dimensional (3-D) multimodal preoperative images onto an external screen during surgery. A calibrated stereovision system was set up between the surgical microscope and the binocular tubes. Three-dimensional surface meshes of the operative field were then generated using stereopsis. These reconstructed 3-D surface meshes were directly displayed without any additional geometrical transform over preoperative images of the patient in the physical space. Performance evaluation was achieved using a physical skull phantom. Accuracy of the reconstruction method itself was shown to be within 1 mm (median: 0.76 mm +/- 0.27), whereas accuracy of the overall approach was shown to be within 3 mm (median: 2.29 mm +/- 0.59), including the image-to-physical space registration error. We report the results of six surgical cases where AV was used in conjunction with augmented reality. AV not only enabled vision beyond the cortical surface but also gave an overview of the surgical area. This approach facilitated understanding of the spatial relationship between the operative field and the preoperative multimodal 3-D images of the patient.
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Affiliation(s)
- Perrine Paul
- Laboratoire IDM, Faculté de Médecine, 35043 Rennes Cedex, France.
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118
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Haegelen C, Verin M, Broche BA, Prigent F, Jannin P, Gibaud B, Morandi X. Does subthalamic nucleus stimulation affect the frontal limbic areas? A single-photon emission computed tomography study using a manual anatomical segmentation method. Surg Radiol Anat 2005; 27:389-94. [PMID: 16160830 DOI: 10.1007/s00276-005-0021-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2004] [Accepted: 06/08/2005] [Indexed: 10/25/2022]
Abstract
Among the basal ganglia nuclei, the subthalamic nucleus (STN) is considered to play a major role in output modulation. The STN represents a relay of the motor cortico-basal ganglia-thalamo-cortical circuit and has become the standard surgical target for treating Parkinson's patients with long-term motor fluctuations and dyskinesia. But chronic bilateral stimulation of the STN produces cognitive effects. According to animal and clinical studies, the STN also appears to have direct or indirect connections with the frontal associative and limbic areas. This prospective study was conducted to analyse regional cerebral blood flow changes in single-photon emission computed tomography imaging of six Parkinson's patients before and after STN stimulation. We particularly focused on the dorsolateral prefrontal cortex and the frontal limbic areas using a manual anatomical MRI segmentation method. We defined nine regions of interest, segmenting each MR slice to quantify the regional cerebral blood flow on pre- and postoperative SPECT images. We normalised the region-of-interest-based measurements to the entire brain volume. The patients showed increased activation during STN stimulation in the dorsolateral prefrontal cortex bilaterally and no change in the anterior cingulate and orbito-frontal cortices. In our study, STN stimulation induced activation of premotor and associative frontal areas. Further studies are needed to underline involvement of the STN with the so-called limbic system.
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Affiliation(s)
- C Haegelen
- Service de Neurochirurgie, Hôpital Pontchaillou, rue Henri Le Guilloux, 35033, Rennes cedex, France
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119
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Grova C, Jannin P, Buvat I, Benali H, Bansard JY, Biraben A, Gibaud B. From anatomic standardization analysis of perfusion SPECT data to perfusion pattern modeling: evidence of functional networks in healthy subjects and temporal lobe epilepsy patients. Acad Radiol 2005; 12:554-65. [PMID: 15866127 PMCID: PMC1978216 DOI: 10.1016/j.acra.2004.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2004] [Accepted: 08/17/2004] [Indexed: 10/25/2022]
Abstract
RATIONALE AND OBJECTIVES In the general context of perfusion pattern modeling from single-photon emission computed tomographic (SPECT) data, the purpose of this study is to characterize interindividual functional variability and functional connectivity between anatomic structures in a set of SPECT data acquired from a homogeneous population of subjects. MATERIALS AND METHODS From volume of interest (VOI)-perfusion measurements performed on anatomically standardized SPECT data, we proposed to use correspondence analysis (CA) and hierarchical clustering (HC) to explore the structure of statistical dependencies among these measurements. The method was applied to study the perfusion pattern in two populations of subjects; namely, SPECT data from 27 healthy subjects and ictal SPECT data from 10 patients with mesio-temporal lobe epilepsy (MTLE). RESULTS For healthy subjects, anatomic structures showing statistically dependent perfusion patterns were classified into four groups; namely, temporomesial structures, internal structures, posterior structures, and remaining cortex. For patients with MTLE, they were classified as temporomesial structures, surrounding temporal structures, internal structures, and remaining cortex. Anatomic structures of each group showed similar perfusion behavior so that they may be functionally connected and may belong to the same network. Our main result is that the temporal pole and lenticular nucleus seemed to be highly relevant to characterize ictal perfusion in patients with MTLE. This exploratory analysis suggests that a network involving temporal structures, lenticular nucleus, brainstem, and cerebellum seems to be involved during MTLE seizures. CONCLUSION CA followed by HC is a promising approach to explore brain perfusion patterns from SPECT VOI measurements.
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Affiliation(s)
- Christophe Grova
- Integration de Donnees Multimedia en Anatomie et Physiologie Cerebrale Pour l'Aide a la Decision et l'Enseignement
INSERM : ERI1Université Rennes IFaculte de Medecine
2, Av du Professeur Leon Bernard
35043 RENNES CEDEX,FR
- Montreal Neurological Institute
McGill UniversityMontreal
Canada,CA
| | - Pierre Jannin
- Integration de Donnees Multimedia en Anatomie et Physiologie Cerebrale Pour l'Aide a la Decision et l'Enseignement
INSERM : ERI1Université Rennes IFaculte de Medecine
2, Av du Professeur Leon Bernard
35043 RENNES CEDEX,FR
| | - Irène Buvat
- Imagerie médicale et quantitative
INSERM : U494CHU Pitié Salpétrière
91 bd de l'Hopital
75634 Paris CEDEX 13,FR
| | - Habib Benali
- Imagerie médicale et quantitative
INSERM : U494CHU Pitié Salpétrière
91 bd de l'Hopital
75634 Paris CEDEX 13,FR
| | - Jean-Yves Bansard
- Laboratoire Traitement du Signal et de l'Image
INSERM : U642Université Rennes ILTSI, Campus de Beaulieu,
Université de Rennes 1,
263 Avenue du Général Leclerc - CS 74205 - 35042 Rennes Cedex,FR
| | - Arnaud Biraben
- Integration de Donnees Multimedia en Anatomie et Physiologie Cerebrale Pour l'Aide a la Decision et l'Enseignement
INSERM : ERI1Université Rennes IFaculte de Medecine
2, Av du Professeur Leon Bernard
35043 RENNES CEDEX,FR
| | - Bernard Gibaud
- Integration de Donnees Multimedia en Anatomie et Physiologie Cerebrale Pour l'Aide a la Decision et l'Enseignement
INSERM : ERI1Université Rennes IFaculte de Medecine
2, Av du Professeur Leon Bernard
35043 RENNES CEDEX,FR
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120
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Aubert-Broche B, Jannin P, Biraben A, Bernard AM, Haegelen C, Le Jeune FP, Gibaud B. Evaluation of methods to detect interhemispheric asymmetry on cerebral perfusion SPECT: application to epilepsy. J Nucl Med 2005; 46:707-13. [PMID: 15809495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
UNLABELLED Detecting perfusion interhemispheric asymmetry in neurologic nuclear medicine imaging is an interesting approach to epilepsy. METHODS This study compared 4 methods that detect interhemispheric asymmetries of brain perfusion in SPECT. The first (M1) was conventional side-by-side expert-based visual interpretation of SPECT. The second (M2) was visual interpretation assisted by an interhemispheric difference (IHD) volume. The last 2 were automatic methods: unsupervised analysis using volumes of interest (M3) and unsupervised analysis of the IHD volume (M4). Use of these methods to detect possible perfusion asymmetry was compared on 60 simulated SPECT datasets by controlling the presence and location of asymmetries. From the detection results, localization receiver operating characteristic curves were generated and areas under curves were estimated and compared. Finally, the methods were applied to analyze interictal SPECT datasets to localize the epileptogenic focus in temporal lobe epilepsies. RESULTS This study showed an improvement in asymmetry detection on SPECT images with the methods using IHD volume (M2 and M4), in comparison with the other methods (M1 and M3). However, the most useful method for analyzing clinical SPECT datasets appeared to be visual inspection assisted by the IHD volume, since the automatic method using the IHD volume was less specific. CONCLUSION The use of quantitative methods can improve performance in detection of perfusion asymmetry over visual inspection alone.
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Affiliation(s)
- Bérengère Aubert-Broche
- Laboratoire Intégration de données multimédia en anatomie et physiologie cérébrale pour l'aide à la décision et l'enseignement, Rennes, France
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121
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Abstract
OBJECTIVE Improvement of the planning stage of image-guided surgery requires a better anticipation of the surgical procedure and its anatomical and functional environment. This anticipation should be provided by acquisition of multimodal medical images of the patient and by a better understanding of surgical procedures. In this paper, we propose improvements to the planning and performance of multimodal image-guided neurosurgery through the use of information models related to neurosurgical procedures. MATERIALS AND METHODS A new generic model of surgical procedures is introduced in the context of multimodal image-guided craniotomies. The basic principle of the model is to break down the surgical procedure into a sequence of steps defining the surgical script. In the model, a step is defined by an action. The model assigns to each surgical step a list of image entities extracted from multimodal preoperative images (i.e., anatomical and/or functional images) which are relevant to the performance of that particular step. A semantic validation of the model was performed by instantiating the model entities for 29 surgical procedures. RESULTS The resulting generic model is described by a UML class diagram and a textual description. The validation showed the relevance of the model, confirming the main underlying assumptions. It also provided some leads to improve the model. CONCLUSION While further validation is needed, the initial benefits of this approach can already be outlined. It should add real value to the different levels of image-guided surgery, from preprocessing to planning, as well as during surgery. Models of surgical procedures can manage image data according to the surgical script, which should lead to better anticipation of surgery through the development of simulation tools. Furthermore, the models may improve the performance of surgery using microscope-based neuronavigation systems by making it possible to adapt both visualization and interaction features of multimodal preoperative images according to the model.
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Affiliation(s)
- P Jannin
- Laboratoire IDM, Faculté de Médécine, Université de Rennes, Rennes, France.
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Grova C, Jannin P, Biraben A, Buvat I, Benali H, Bernard AM, Scarabin JM, Gibaud B. A methodology for generating normal and pathological brain perfusion SPECT images for evaluation of MRI/SPECT fusion methods: application in epilepsy. Phys Med Biol 2003; 48:4023-43. [PMID: 14727749 DOI: 10.1088/0031-9155/48/24/003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Quantitative evaluation of brain MRI/SPECT fusion methods for normal and in particular pathological datasets is difficult, due to the frequent lack of relevant ground truth. We propose a methodology to generate MRI and SPECT datasets dedicated to the evaluation of MRI/SPECT fusion methods and illustrate the method when dealing with ictal SPECT. The method consists in generating normal or pathological SPECT data perfectly aligned with a high-resolution 3D T1-weighted MRI using realistic Monte Carlo simulations that closely reproduce the response of a SPECT imaging system. Anatomical input data for the SPECT simulations are obtained from this 3D T1-weighted MRI, while functional input data result from an inter-individual analysis of anatomically standardized SPECT data. The method makes it possible to control the 'brain perfusion' function by proposing a theoretical model of brain perfusion from measurements performed on real SPECT images. Our method provides an absolute gold standard for assessing MRI/SPECT registration method accuracy since, by construction, the SPECT data are perfectly registered with the MRI data. The proposed methodology has been applied to create a theoretical model of normal brain perfusion and ictal brain perfusion characteristic of mesial temporal lobe epilepsy. To approach realistic and unbiased perfusion models, real SPECT data were corrected for uniform attenuation, scatter and partial volume effect. An anatomic standardization was used to account for anatomic variability between subjects. Realistic simulations of normal and ictal SPECT deduced from these perfusion models are presented. The comparison of real and simulated SPECT images showed relative differences in regional activity concentration of less than 20% in most anatomical structures, for both normal and ictal data, suggesting realistic models of perfusion distributions for evaluation purposes. Inter-hemispheric asymmetry coefficients measured on simulated data were found within the range of asymmetry coefficients measured on corresponding real data. The features of the proposed approach are compared with those of other methods previously described to obtain datasets appropriate for the assessment of fusion methods.
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Affiliation(s)
- C Grova
- Laboratoire IDM, Faculté de Médecine, Université de Rennes 1, Rennes, France.
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123
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Toulouse P, Agulhon C, Taussig D, Napuri S, Biraben A, Jannin P, Carsin M, Scarabin JM. Magnetoencephalographic studies of two cases of diffuse subcortical laminar heterotopia or so-called double cortex. Neuroimage 2003; 19:1251-9. [PMID: 12948686 DOI: 10.1016/s1053-8119(03)00173-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Two cases (a young male and a girl, suffering intractable epilepsy) of diffuse subcortical laminar heterotopia, or so-called double cortex (DC) have been investigated using magnetoencephalography (MEG). MEG confirmed involvement of both cortices (hetero- and normocortex) in the genesis of interictal spikes, and, according to the heterogeneity of DC syndrome, some differences were observed: spike initiation in the normocortex and latter involvement of the heterotopic cortex in the man, and rather a cancellation in both cortices in the girl. In addition, participation of heterotopic cortex in physiological activities could be demonstrated in the man.
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MESH Headings
- Adult
- Brain Mapping
- Cerebral Cortex/physiopathology
- Child
- Choristoma
- Epilepsies, Partial/congenital
- Epilepsies, Partial/physiopathology
- Epilepsy, Generalized/congenital
- Epilepsy, Generalized/physiopathology
- Evoked Potentials, Auditory/physiology
- Evoked Potentials, Somatosensory/physiology
- Female
- Humans
- Image Processing, Computer-Assisted
- Imaging, Three-Dimensional
- Infant
- Magnetic Resonance Imaging
- Male
- Spasms, Infantile/congenital
- Spasms, Infantile/physiopathology
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Affiliation(s)
- Pierre Toulouse
- Laboratoire de Physiologie-Explorations Fonctionnelles, Université de Rennes I, CHU Rennes, Rue Henri Le Guilloux, 35033 Rennes Cedex, France.
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124
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Abstract
Technetium-99m HMPAO and technetium-99m ECD single photon emission computed tomography (SPECT) imaging is commonly used to highlight brain regions with altered perfusion. It is particularly useful in the investigation of intractable partial epilepsy. However, SPECT suffers from poor spatial resolution that makes interpretation difficult. In this context, we propose an unsupervised voxel neighbourhood based method to assist the detection of significant functional inter-hemispheric asymmetries in brain SPECT, using anatomical information from MRI. For each MRI voxel, the anatomically homologous voxel in the contralateral hemisphere is identified. Both homologous voxel coordinates are then mapped into the SPECT volume using SPECT-MRI registration. Neighbourhoods are then defined around each SPECT voxel and compared to obtain a volume of inter-hemispheric differences. A volume including only the statistically significant inter-hemispheric differences is deduced from this volume using a non-parametric approach. The method was validated using realistic analytical simulated SPECT data including known asymmetries (in size and amplitude) as ground truth (gold standard). Detection performance was assessed using an ROC (receiver operating characteristic) approach based on the measures of the overlap between known and detected asymmetries. Validation with computer-simulated data demonstrates the ability to detect asymmetric zones with relatively small extension and amplitude. The registration of these detected functional asymmetries on the MRI enables good anatomical localization to be achieved.
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Affiliation(s)
- B Aubert-Broche
- Laboratoire IDM, Faculté de Médecine, Université de Rennes 1, Rennes, France.
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125
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Raimbault M, Jannin P, Morandi X, Riffaud L, Gibaud B. Models of surgical procedures for multimodal image-guided neurosurgery. Stud Health Technol Inform 2003; 95:50-5. [PMID: 14663962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Improvement of image guided surgery systems requires a better anticipation of the surgical procedure. This anticipation may be provided by a better understanding of surgical procedures and/or the use of information models related to neurosurgical procedures. We are introducing a generic model of surgical procedures in the context of multimodal image-guided craniotomies. The basic principle of the model is to break down the surgical procedure into a sequence of steps defining the surgical script. Each step is defined by an action; the model assigns to each surgical step a list of image entities extracted from multimodal preoperative images (anatomical and/or functional images) which are relevant to the performance of that particular step. The model has been built in two phases: creation and consolidation. Besides, a planning software prototype based on the generic model has been built. The resulting generic model is described by an UML class diagram and textual description. Some initial benefits of this approach can already be outlined: improvement of multimodal information management, enhancement of the preparation and the guidance of the surgical act.
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126
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Jannin P, Fitzpatrick JM, Hawkes DJ, Pennec X, Shahidi R, Vannier MW. Validation of medical image processing in image-guided therapy. IEEE Trans Med Imaging 2002; 21:1445-1449. [PMID: 12588028 DOI: 10.1109/tmi.2002.806568] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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127
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Jannin P, Morandi X, Fleig OJ, Le Rumeur E, Toulouse P, Gibaud B, Scarabin JM. Integration of sulcal and functional information for multimodal neuronavigation. J Neurosurg 2002; 96:713-23. [PMID: 11990812 DOI: 10.3171/jns.2002.96.4.0713] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The authors present the use of cortical sulci, segmented from magnetic resonance (MR) imaging, and functional data from functional (f)MR imaging and magnetoencephalography (MEG) in the image-guided surgical management of lesions adjacent to the sensorimotor cortex. METHODS In an initial set of 11 patients, sulci near lesions were automatically segmented from MR imaging data sets, then MEG and fMR imaging examinations were performed. Relevant functional information was preoperatively interpreted and selected from MEG and fMR imaging and subsequently transferred to the navigation system for selected sulci. A neuronavigation system consisting of a surgical microscope with enhanced reality overlay display was used. Data were displayed as contours on the cut-plane images of a stereotactic workstation and as contours on the overlay screen of the head-up display within the optical path of the right eyepiece of the surgical microscope. CONCLUSIONS This method, in which both sulcal and functional mapping are used for surgery planning and neuronavigation, provides helpful information. It is a promising procedure for the treatment of patients who harbor lesions in areas around the eloquent cortex.
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Affiliation(s)
- Pierre Jannin
- Laboratoire IDM and LRMBM, Faculté de Médecine Univsersité de Rennes, France.
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128
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Grova C, Jannin P, Biraben A, Scarabin J, Benali H, Gubaud B. Generation of realistic models of ictal SPECT using Monte-Carlo simulations. Neuroimage 2001. [DOI: 10.1016/s1053-8119(01)91480-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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129
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Jannin P, Seigneuret E, Morandi X, Fleig OJ, Riffaud L, Brassier G, Scarabin JM. [Sulcal identification and neuronavigation in supratentorial cavernoma surgery]. Neurochirurgie 2000; 46:534-9; discussion 539-40. [PMID: 11148406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We present the use of cortical sulci, segmented from magnetic resonance imaging, in image guided neurosurgery. Sulcal information was transferred to a surgical microscope with enhanced reality features. This assistance was used for the resection of supratentorial cavernomas (7 patients). Sulci were semi-automatically segmented from 3D MRI data sets. Sulci close to the cavernoma were selected and transferred to the neuronavigation system which allows the superimposition of graphics into the right ocular of the microscope. Selected sulci were displayed on the workstation and superimposed into the ocular of the microscope. Cortical sulci proved to be useful for the recognition of the anatomical environment. The superimposed sulci helped to optimize location and size of the skin incision as well as to guide the access to the cavernoma by using the course of a sulcus as indirect trajectory.
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Affiliation(s)
- P Jannin
- Laboratoire IDM UPRES EA, Faculté de Médecine, Université de Rennes 1, 35043 Rennes Cedex
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130
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Le Rumeur E, Allard M, Poiseau E, Jannin P. Role of the mode of sensory stimulation in presurgical brain mapping in which functional magnetic resonance imaging is used. J Neurosurg 2000; 93:427-31. [PMID: 10969940 DOI: 10.3171/jns.2000.93.3.0427] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The aim of this study was to evaluate different types of sensory stimulation used to distinguish between microvasculature and venous drainage on functional magnetic resonance (fMR) images with blood oxygen level-dependent (BOLD) contrast. METHODS Seven volunteers received three sensory stimulations. One consisted of small discontinuous automated pokes to the ventral aspect of the right thumbtip. The other two were delivered by the investigator, who vigorously brushed the ventral aspect of the right thumbtip either alone or in combination with the thenar region. Seven contiguous axial slices of the head were acquired using echoplanar fMR imaging during each mode of stimulation. Boxcar analysis and Student's t-test were performed. Cluster analysis was used to determine significant differences between rest and activation phases. The major findings were 1) that a discontinuous sensory stimulation involving a small skin area was able to evoke a limited activated area in the postcentral gyrus with a low activation index (AI [2%]); 2) that this limited activated area was included in the activated area elicited by the continuous sensory stimulations; and 3) that this also evoked multiple activated areas exhibiting AIs of either approximately 2% or greater than 5%. This indicated that the limited discontinuous tactile stimulation evoked a BOLD-contrast fMR image essentially of microvasculature, whereas the more extensive continuous stimulations evoked a BOLD-contrast fMR image in both microvasculature and venous drainage. CONCLUSIONS Different sensory stimulations are necessary to differentiate primary sensory cortex from venous drainage for presurgical brain mapping.
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Affiliation(s)
- E Le Rumeur
- Fédération d'Imagerie Médicale, Centre Hospitalier Regional Pontchaillou, Rennes, France.
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131
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Jannin P, Fleig OJ, Seigneuret E, Grova C, Morandi X, Scarabin JM. A data fusion environment for multimodal and multi-informational neuronavigation. Comput Aided Surg 2000; 5:1-10. [PMID: 10767090 DOI: 10.1002/(sici)1097-0150(2000)5:1<1::aid-igs1>3.0.co;2-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Part of the planning and performance of neurosurgery consists of determining target areas, areas to be avoided, landmark areas, and trajectories, all of which are components of the surgical script. Nowadays, neurosurgeons have access to multimodal medical imaging to support the definition of the surgical script. The purpose of this paper is to present a software environment developed by the authors that allows full multimodal and multi-informational planning as well as neuronavigation for epilepsy and tumor surgery. MATERIALS AND METHODS We have developed a data fusion environment dedicated to neuronavigation around the Surgical Microscope Neuronavigator system (Carl Zeiss, Oberkochen, Germany). This environment includes registration, segmentation, 3D visualization, and interaction-applied tools. It provides the neuronavigation system with the multimodal information involved in the definition of the surgical script: lesional areas, sulci, ventricles segmented from magnetic resonance imaging (MRI), vessels segmented from magnetic resonance angiography (MRA), functional areas from magneto-encephalography (MEG), and functional magnetic resonance imaging (fMRI) for somatosensory, motor, or language activation. These data are considered to be relevant for the performance of the surgical procedure. The definition of each entity results from the same procedure: registration to the anatomical MRI data set (defined as the reference data set), segmentation, fused 3D display, selection of the relevant entities for the surgical step, encoding in 3D surface-based representation, and storage of the 3D surfaces in a file recognized by the neuronavigation software (STP 3.4, Leibinger; Freiburg, Germany). RESULTS Multimodal neuronavigation is illustrated with two clinical cases for which multimodal information was introduced into the neuronavigation system. Lesional areas were used to define and follow the surgical path, sulci and vessels helped identify the anatomical environment of the surgical field, and, finally, MEG and fMRI functional information helped determine the position of functional high-risk areas. CONCLUSION In this short evaluation, the ability to access preoperative multi-functional and anatomical data within the neuronavigation system was a valuable support for the surgical procedure.
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Affiliation(s)
- P Jannin
- Laboratoire SIM, UPRES E.A. 2232, Université de Rennes, France.
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Jannin P, Bouliou A, Journet E, Scarabin JM. A ray-traced texture mapping for enhanced virtuality in image-guided neurosurgery. Stud Health Technol Inform 1995; 29:553-63. [PMID: 10163783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
3D imaging systems and algorithms give virtual representations of the real world. New emergent hardware systems can combine virtual information and the real world. Virtual and real information must be also visually confronted in order to facilitate our comprehension of the data. We propose a solution which entails the superimposition of a real image of the anatomical areas visualised in a surgical operation with 3D digital data sets. Unlike other solutions which display virtual images in the real world, our method involves ray traced texture mapping which displays real images in a computed world.
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Affiliation(s)
- P Jannin
- Laboratoire SIM/CERIUM, Rennes, France.
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