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Bex A, Mathon B. Advances, technological innovations, and future prospects in stereotactic brain biopsies. Neurosurg Rev 2022; 46:5. [PMID: 36471144 PMCID: PMC9734929 DOI: 10.1007/s10143-022-01918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stereotactic brain biopsy is one of the most frequently performed brain surgeries. This review aimed to expose the latest cutting-edge and updated technologies and innovations available to neurosurgeons to safely perform stereotactic brain biopsy by minimizing the risks of complications and ensuring that the procedure is successful, leading to a histological diagnosis. We also examined methods for improving preoperative, intraoperative, and postoperative workflows. We performed a comprehensive state-of-the-art literature review. Intraoperative histology, fluorescence, and imaging techniques appear as smart tools to improve the diagnostic yield of biopsy. Constant innovations such as optical methods and augmented reality are also being made to increase patient safety. Robotics and integrated imaging techniques provide an enhanced intraoperative workflow. Patients' management algorithms based on early discharge after biopsy optimize the patient's personal experience and make the most efficient possible use of the available hospital resources. Many new trends are emerging, constantly improving patient care and safety, as well as surgical workflow. A parameter that must be considered is the cost-effectiveness of these devices and the possibility of using them on a daily basis. The decision to implement a new instrument in the surgical workflow should also be dependent on the number of procedures per year, the existing stereotactic equipment, and the experience of each center. Research on patients' postbiopsy management is another mandatory approach to enhance the safety profile of stereotactic brain biopsy and patient satisfaction, as well as to reduce healthcare costs.
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Affiliation(s)
- Alix Bex
- Department of Neurosurgery, CHR Citadelle, Liege, Belgium
| | - Bertrand Mathon
- Department of Neurosurgery, Sorbonne University, APHP, La Pitié-Salpêtrière Hospital, 47-83, Boulevard de L'Hôpital, 75651 Cedex 13, Paris, France.
- ICM, INSERM U 1127, CNRS UMR 7225, UMRS, Paris Brain Institute, Sorbonne University, 1127, Paris, France.
- GRC 23, Brain Machine Interface, APHP, Sorbonne University, Paris, France.
- GRC 33, Robotics and Surgical Innovation, APHP, Sorbonne University, Paris, France.
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Survey of practice preferences in deep brain stimulation surgery in the United States. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2021.101463] [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] Open
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Park HR, Lim YH, Song EJ, Lee JM, Park K, Park KH, Lee WW, Kim HJ, Jeon B, Paek SH. Bilateral Subthalamic Nucleus Deep Brain Stimulation under General Anesthesia: Literature Review and Single Center Experience. J Clin Med 2020; 9:jcm9093044. [PMID: 32967337 PMCID: PMC7564882 DOI: 10.3390/jcm9093044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 02/07/2023] Open
Abstract
Bilateral subthalamic nucleus (STN) Deep brain stimulation (DBS) is a well-established treatment in patients with Parkinson's disease (PD). Traditionally, STN DBS for PD is performed by using microelectrode recording (MER) and/or intraoperative macrostimulation under local anesthesia (LA). However, many patients cannot tolerate the long operation time under LA without medication. In addition, it cannot be even be performed on PD patients with poor physical and neurological condition. Recently, it has been reported that STN DBS under general anesthesia (GA) can be successfully performed due to the feasible MER under GA, as well as the technical advancement in direct targeting and intraoperative imaging. The authors reviewed the previously published literature on STN DBS under GA using intraoperative imaging and MER, focused on discussing the technique, clinical outcome, and the complication, as well as introducing our single-center experience. Based on the reports of previously published studies and ours, GA did not interfere with the MER signal from STN. STN DBS under GA without intraoperative stimulation shows similar or better clinical outcome without any additional complication compared to STN DBS under LA. Long-term follow-up with a large number of the patients would be necessary to validate the safety and efficacy of STN DBS under GA.
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Affiliation(s)
- Hye Ran Park
- Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea;
| | - Yong Hoon Lim
- Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea; (Y.H.L.); (E.J.S.)
| | - Eun Jin Song
- Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea; (Y.H.L.); (E.J.S.)
| | - Jae Meen Lee
- Department of Neurosurgery, Pusan National University Hospital, Busan 49241, Korea;
| | - Kawngwoo Park
- Department of Neurosurgery, Gachon University Gil Medical Center, Incheon 21565, Korea;
| | - Kwang Hyon Park
- Department of Neurosurgery, Chuungnam National University Sejong Hospital, Sejong 30099, Korea;
| | - Woong-Woo Lee
- Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea;
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul 03080, Korea; (H.-J.K.); (B.J.)
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul 03080, Korea; (H.-J.K.); (B.J.)
| | - Sun Ha Paek
- Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea; (Y.H.L.); (E.J.S.)
- Correspondence: ; Tel.: +82-22-072-2876
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Wang J, Ponce FA, Tao J, Yu HM, Liu JY, Wang YJ, Luan GM, Ou SW. Comparison of Awake and Asleep Deep Brain Stimulation for Parkinson's Disease: A Detailed Analysis Through Literature Review. Neuromodulation 2019; 23:444-450. [PMID: 31830772 DOI: 10.1111/ner.13061] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/22/2019] [Accepted: 09/11/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Deep brain stimulation (DBS) for Parkinson's disease (PD) has been applied to clinic for approximately 30 years. The goal of this review is to explore the similarities and differences between "awake" and "asleep" DBS techniques. METHODS A comprehensive literature review was carried out to identify relevant studies and review articles describing applications of "awake" or "asleep" DBS for Parkinson's disease. The surgical procedures, clinical outcomes, costs and complications of each technique were compared in detail through literature review. RESULTS The surgical procedures of awake and asleep DBS surgeries rely upon different methods for verification of intended target acquisition. The existing research results demonstrated that the stereotactic targeting accuracy of lead placement obtained by either method is reliable. There were no significant differences in clinical outcomes, costs, or complications between the two techniques. CONCLUSION The surgical and clinical outcomes of asleep DBS for PD are comparable to those of awake DBS.
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Affiliation(s)
- Jun Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, P. R., China
| | - Francisco A Ponce
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Jun Tao
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, P. R., China
| | - Hong-Mei Yu
- Department of Neurology, The First Hospital of China Medical University, Shenyang, P. R., China
| | - Ji-Yuan Liu
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, P. R., China
| | - Yun-Jie Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, P. R., China
| | - Guo-Ming Luan
- Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, P. R., China
| | - Shao-Wu Ou
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, P. R., China
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Effects of Habenular Stimulation Frequencies on Obstructive Sleep Apnea Induced by Stimulation of Insular Cortex. Can Respir J 2018; 2018:9060678. [PMID: 29796137 PMCID: PMC5896235 DOI: 10.1155/2018/9060678] [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: 08/31/2017] [Revised: 12/26/2017] [Accepted: 01/22/2018] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the effects of high-frequency stimulation of the habenula (Hb) on obstructive sleep apnea (OSA) induced by stimulation of the insular cortex Method. After OSA was induced by stimulating the insular cortex (Ic) with concentric stimulating electrodes at 100 Hz in rats, the Hb was stimulated at different frequencies (50 Hz, 120 Hz, 130 Hz, and 280 Hz). The changes of apnea events and electromyography (EMG) of the genioglossus were compared before and after stimulation of the Hb. Results With stimulation of the Ic at 100 Hz, apnea events were successfully induced with disappearance of EMG of the genioglossus. After stimulation of the Hb at 130 Hz, apnea events disappeared with significantly increased genioglossal EMG. However, such a change failed to be found at the stimulation frequencies of 50 Hz, 120 Hz, and 280 Hz. Conclusion Stimulation of the Hb at the frequency of 130 Hz could effectively inhibit OSA events induced by stimulation of the Ic.
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Virdyawan V, Oldfield M, Rodriguez Y Baena F. Laser Doppler sensing for blood vessel detection with a biologically inspired steerable needle. BIOINSPIRATION & BIOMIMETICS 2018; 13:026009. [PMID: 29323660 DOI: 10.1088/1748-3190/aaa6f4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Puncturing blood vessels during percutaneous intervention in minimally invasive brain surgery can be a life threatening complication. Embedding a forward looking sensor in a rigid needle has been proposed to tackle this problem but, when using a rigid needle, the procedure needs to be interrupted and the needle extracted if a vessel is detected. As an alternative, we propose a novel optical method to detect a vessel in front of a steerable needle. The needle itself is based on a biomimetic, multi-segment design featuring four hollow working channels. Initially, a laser Doppler flowmetry probe is characterized in a tissue phantom with optical properties mimicking those of human gray matter. Experiments are performed to show that the probe has a 2.1 mm penetration depth and a 1 mm off-axis detection range for a blood vessel phantom with 5 mm s-1 flow velocity. This outcome demonstrates that the probe fulfills the minimum requirements for it to be used in conjunction with our needle. A pair of Doppler probes is then embedded in two of the four working channels of the needle and vessel reconstruction is performed using successive measurements to determine the depth and the off-axis position of the vessel from each laser Doppler probe. The off-axis position from each Doppler probe is then used to generate a 'detection circle' per probe, and vessel orientation is predicted using tangent lines between the two. The vessel reconstruction has a depth root mean square error (RMSE) of 0.3 mm and an RMSE of 15° in the angular prediction, showing real promise for a future clinical application of this detection system.
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Affiliation(s)
- V Virdyawan
- Mechanical Engineering Department, Imperial College London, London SW7 2AZ, United Kingdom
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Ciszkiewicz A, Milewski G. Path planning for minimally-invasive knee surgery using a hybrid optimization procedure. Comput Methods Biomech Biomed Engin 2018; 21:47-54. [PMID: 29318898 DOI: 10.1080/10255842.2017.1423289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to develop a procedure for medical tool path planning in minimally-invasive knee surgery. The collision-free paths for the tool were obtained using the control locations method with a hybrid optimization strategy. The tool and knee elements were described with surface meshes. The knee model allowed for bones displacement and variable incision size and location. The proposed procedure was proven to be effective in path planning for minimally-invasive surgery. It can serve as a valuable aid in surgery planning and may also be used in systems for autonomous or semi-autonomous knee surgery.
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Affiliation(s)
- Adam Ciszkiewicz
- a Division of Experimental Mechanics and Biomechanics, Institute of Applied Mechanics , Cracow University of Technology , Cracow , Poland
| | - Grzegorz Milewski
- a Division of Experimental Mechanics and Biomechanics, Institute of Applied Mechanics , Cracow University of Technology , Cracow , Poland
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Ciszkiewicz A, Lorkowski J, Milewski G. A novel planning solution for semi-autonomous aspiration of Baker's cysts. Int J Med Robot 2018; 14. [PMID: 29316179 DOI: 10.1002/rcs.1882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 07/10/2017] [Accepted: 08/15/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND A Baker's cyst is a pathological structure located near a kneepit, which causes discomfort and reduces mobility of the knee. It is commonly treated with aspiration, which often requires MRI scanning and US guidance. The aim of this study was to propose a novel planning solution for semi-autonomous aspiration of the Baker's cyst using only MRI imaging. METHODS The proposed method requires minimal user input and offers automatic cyst segmentation with collision-free path planning for the assumed robotic structure with four degrees of freedom. RESULTS The prepared software was tested on four image sets obtained from patients eligible for cyst aspiration. It was possible to accurately segment the cyst in the considered cases. The collision-free path planning method was investigated in numerical scenarios. CONCLUSIONS The simulations verified the proposed software solution. Future work will be devoted to experimental verification of the path planning procedure.
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Affiliation(s)
- Adam Ciszkiewicz
- Institute of Applied Mechanics, Cracow University of Technology, Cracow, Poland
| | - Jacek Lorkowski
- Department of Orthopaedics and Traumatology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Grzegorz Milewski
- Institute of Applied Mechanics, Cracow University of Technology, Cracow, Poland
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Mohyeldin A, Elder JB. Stereotactic Biopsy Platforms with Intraoperative Imaging Guidance. Neurosurg Clin N Am 2017; 28:465-475. [DOI: 10.1016/j.nec.2017.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Functional neurosurgery has undergone rapid growth over the last few years fueled by advances in imaging technology and novel treatment modalities. These advances have led to new surgical treatments using minimally invasive and precise techniques for conditions such as Parkinson's disease, essential tremor, epilepsy, and psychiatric disorders. Understanding the goals and technological issues of these procedures is imperative for the anesthesiologist to ensure safe management of patients presenting for functional neurosurgical procedures. In this review, we discuss the advances in neurosurgical techniques for deep brain stimulation, focused ultrasound and minimally invasive laser-based treatment of refractory epilepsy and provide a guideline for anesthesiologists caring for patients undergoing these procedures.
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Park DW, Brodnick SK, Ness JP, Atry F, Krugner-Higby L, Sandberg A, Mikael S, Richner TJ, Novello J, Kim H, Baek DH, Bong J, Frye ST, Thongpang S, Swanson KI, Lake W, Pashaie R, Williams JC, Ma Z. Fabrication and utility of a transparent graphene neural electrode array for electrophysiology, in vivo imaging, and optogenetics. Nat Protoc 2016; 11:2201-2222. [DOI: 10.1038/nprot.2016.127] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/19/2016] [Indexed: 11/09/2022]
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Delavallée M, Delaunois J, Ruwet J, Jeanjean A, Raftopoulos C. STN DBS for Parkinson's disease: results from a series of ten consecutive patients implanted under general anaesthesia with intraoperative use of 3D fluoroscopy to control lead placement. Acta Neurochir (Wien) 2016; 158:1783-8. [PMID: 27405941 DOI: 10.1007/s00701-016-2889-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 06/22/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) of the sub-thalamic nucleus (STN) is a recognised treatment for advanced Parkinson's disease (PD). We present our results of 10 consecutive patients implanted under general anaesthesia (GA) using intraoperative robotic three-dimensional (3D) fluoroscopy (Artis Zeego; Siemens, Erlangen, Germany). METHOD Ten patients (nine men, one woman) with a mean age of 57.6 (range, 41-67) years underwent surgery between October 2013 and January 2015. The mean duration of PD was 9.2 [1-10] year. The procedure was performed under GA: placement of the stereotactic frame, implantation of the electrodes (Lead 3389; Medtronic, Minnesota, MN, USA) and 3D intraoperative fluoroscopic control (Artis Zeego) with image fusion with the preoperative MRI scans. All patients were evaluated preoperatively and 6 months postoperatively. RESULTS The mean operative time was 240.1 (185-325) min. The mean Unified Parkinson's Disease Rating Scale (UPDRS) II OFF medication decreased from 23.9 preoperatively to 15.7 postoperatively. The mean OFF medication UPDRS III decreased from 41 to 11.6 and the UPDRS IV decreased from 10.6 to 7. The mean preoperative and postoperative L-Dopa doses were 1,178.5 and 696.5 mg, respectively. Two complications were recorded: one episode of transient confusion (24 h) and one internal pulse generator (IPG) infection. CONCLUSIONS With improvement in preoperative magnetic resonance imaging (MRI) and the ability to control the position of the leads intraoperatively using Artis Zeego, we now perform this procedure under GA. Our results are comparable to others reported. The significant decrease in the duration of surgery could be associated with a reduced rate of complications (infection, loss of patient collaboration). However, this observation needs to be confirmed.
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Maiti TK, Konar S, Bir S, Kalakoti P, Nanda A. Intra-operative micro-electrode recording in functional neurosurgery: Past, present, future. J Clin Neurosci 2016; 32:166-72. [PMID: 27396672 DOI: 10.1016/j.jocn.2016.03.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 03/24/2016] [Accepted: 03/28/2016] [Indexed: 11/25/2022]
Abstract
The field of functional neurosurgery has experienced a rise, fall and lastly a renaissance over the past 75years. Micro-electrode recording (MER) played a key role during this eventful journey. However, as the intra-operative MRI continues to evolve, a pertinent question about the utility of MER has been raised in recent years. In this article, we critically review these current controversies. The English literature is reviewed and the complex technique of MER is discussed in a simplified manner. The improvement of neuroimaging and its application in functional neurosurgery, especially in deep brain stimulation, is discussed. Finally, the current controversies and technical advances which can direct the future are reviewed. The results of existing meta-analyses addressing the controversies are summarized. Wide variations of pre-operative and intra-operative targeting methods have been described in the literature. Though functional neurosurgery is generally safe, complications do occur and multiple passes during MER can certainly add to the risk of inadvertent hemorrhage and infection. Additionally, the recent introduction of newer MRI modalities has ensured better delineation of the target. However, MER is still useful to address brain shift, for mapping of newer targets, for ablative surgeries and in centers without an intra-operative imaging facility. In the current scenario, it is nearly impossible to conduct a prospective study to decide the utility of MER. The importance of MER may further diminish in the future as a routine procedure, but its role as a gold standard procedure may still persist.
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Affiliation(s)
- Tanmoy K Maiti
- Department of Neurosurgery, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71130-3932, USA
| | - Subhas Konar
- Department of Neurosurgery, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71130-3932, USA
| | - Shyamal Bir
- Department of Neurosurgery, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71130-3932, USA
| | - Piyush Kalakoti
- Department of Neurosurgery, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71130-3932, USA
| | - Anil Nanda
- Department of Neurosurgery, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71130-3932, USA.
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Zerroug A, Gabrillargues J, Coll G, Vassal F, Jean B, Chabert E, Claise B, Khalil T, Sakka L, Feschet F, Durif F, Boyer L, Coste J, Lemaire JJ. Personalized mapping of the deep brain with a white matter attenuated inversion recovery (WAIR) sequence at 1.5-tesla: Experience based on a series of 156 patients. Neurochirurgie 2016; 62:183-9. [PMID: 27236731 DOI: 10.1016/j.neuchi.2016.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/29/2015] [Accepted: 01/26/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Deep brain mapping has been proposed for direct targeting in stereotactic functional surgery, aiming to personalize electrode implantation according to individual MRI anatomy without atlas or statistical template. We report our clinical experience of direct targeting in a series of 156 patients operated on using a dedicated Inversion Recovery Turbo Spin Echo sequence at 1.5-tesla, called White Matter Attenuated Inversion Recovery (WAIR). METHODS After manual contouring of all pertinent structures and 3D planning of trajectories, 312 DBS electrodes were implanted. Detailed anatomy of close neighbouring structures, whether gray nuclei or white matter regions, was identified during each planning procedure. We gathered the experience of these 312 deep brain mappings and elaborated consistent procedures of anatomical MRI mapping for pallidal, subthalamic and ventral thalamic regions. We studied the number of times the central track anatomically optimized was selected for implantation of definitive electrodes. RESULTS WAIR sequence provided high-quality images of most common functional targets, successfully used for pure direct stereotactic targeting: the central track corresponding to the optimized primary anatomical trajectory was chosen for implantation of definitive electrodes in 90.38%. CONCLUSION WAIR sequence is anatomically reliable, enabling precise deep brain mapping and direct stereotactic targeting under routine clinical conditions.
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Affiliation(s)
- A Zerroug
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - J Gabrillargues
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - G Coll
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - F Vassal
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France
| | - B Jean
- Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - E Chabert
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - B Claise
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of radiology, neuroradiology unit, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - T Khalil
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - L Sakka
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - F Feschet
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France
| | - F Durif
- Service of neurology, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - L Boyer
- Service of radiology, CHU de Clermont-Ferrand, 63003 Clemront-Ferrand, France
| | - J Coste
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J-J Lemaire
- Image-guided clinical neuroscience and connectomics, Clermont université, université d'Auvergne, EA7282, 63000 Clermont-Ferrand, France; Service of neurosurgery, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
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Saleh S, Swanson KI, Lake WB, Sillay KA. Awake Neurophysiologically Guided versus Asleep MRI-Guided STN DBS for Parkinson Disease: A Comparison of Outcomes Using Levodopa Equivalents. Stereotact Funct Neurosurg 2016; 93:419-26. [DOI: 10.1159/000442425] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/12/2015] [Indexed: 11/19/2022]
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Mohyeldin A, Lonser RR, Elder JB. Real-time magnetic resonance imaging-guided frameless stereotactic brain biopsy: technical note. J Neurosurg 2015; 124:1039-46. [PMID: 26495951 DOI: 10.3171/2015.5.jns1589] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The object of this study was to assess the feasibility, accuracy, and safety of real-time MRI-compatible frameless stereotactic brain biopsy. METHODS Clinical, imaging, and histological data in consecutive patients who underwent stereotactic brain biopsy using a frameless real-time MRI system were analyzed. RESULTS Five consecutive patients (4 males, 1 female) were included in this study. The mean age at biopsy was 45.8 years (range 29-60 years). Real-time MRI permitted concurrent display of the biopsy cannula trajectory and tip during placement at the target. The mean target depth of biopsied lesions was 71.3 mm (range 60.4-80.4 mm). Targeting accuracy analysis revealed a mean radial error of 1.3 ± 1.1 mm (mean ± standard deviation), mean depth error of 0.7 ± 0.3 mm, and a mean absolute tip error of 1.5 ± 1.1 mm. There was no correlation between target depth and absolute tip error (Pearson product-moment correlation coefficient, r = 0.22). All biopsy cannulae were placed at the target with a single penetration and resulted in a diagnostic specimen in all cases. Histopathological evaluation of biopsy samples revealed dysembryoplastic neuroepithelial tumor (1 case), breast carcinoma (1 case), and glioblastoma multiforme (3 cases). CONCLUSIONS The ability to place a biopsy cannula under real-time imaging guidance permits on-the-fly alterations in the cannula trajectory and/or tip placement. Real-time imaging during MRI-guided brain biopsy provides precise safe targeting of brain lesions.
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Affiliation(s)
- Ahmed Mohyeldin
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio
| | - Russell R Lonser
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio
| | - J Bradley Elder
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio
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18
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Córcoles J, Zastrow E, Kuster N. Convex optimization of MRI exposure for mitigation of RF-heating from active medical implants. Phys Med Biol 2015; 60:7293-308. [DOI: 10.1088/0031-9155/60/18/7293] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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19
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Metman LV, Slavin KV. Advances in functional neurosurgery for Parkinson's disease. Mov Disord 2015; 30:1461-70. [DOI: 10.1002/mds.26338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 06/23/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Konstantin V. Slavin
- Department of Neurosurgery; University of Illinois at Chicago; Chicago Illinois USA
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20
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Bisdas S, Roder C, Ernemann U, Tatagiba MS. Intraoperative MR Imaging in Neurosurgery. Clin Neuroradiol 2015; 25 Suppl 2:237-44. [PMID: 26259854 DOI: 10.1007/s00062-015-0443-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/17/2015] [Indexed: 12/01/2022]
Abstract
Intraoperative magnetic resonance imaging (iMRI) has dramatically expanded and nowadays presents state-of-the-art technique for image-guided neurosurgery, facilitating critical precision and effective surgical treatment of various brain pathologies. Imaging hardware providing basic imaging sequences as well as advanced MRI can be seamlessly integrated into routine surgical environments, which continuously leads to emerging indications for iMRI-assisted surgery. Besides the obvious intraoperative diagnostic yield, the initial clinical benefits have to be confirmed by future-controlled long-term studies.
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Affiliation(s)
- S Bisdas
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University Hospital, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - C Roder
- Department of Neurosurgery, Eberhard Karls University Hospital, Tübingen, Germany
| | - U Ernemann
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University Hospital, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - M S Tatagiba
- Department of Neurosurgery, Eberhard Karls University Hospital, Tübingen, Germany
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