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Shinn RL, Hollingsworth C, Parker RL, Rossmeisl JH, Werre SR. Comparison of stereotactic brain biopsy techniques in dogs: neuronavigation, 3D-printed guides, and neuronavigation with 3D-printed guides. Front Vet Sci 2024; 11:1406928. [PMID: 38915886 PMCID: PMC11194692 DOI: 10.3389/fvets.2024.1406928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/29/2024] [Indexed: 06/26/2024] Open
Abstract
The objective of this research was to compare two previously described stereotactic brain biopsy (SBB) techniques, three-dimensional skull contoured guides (3D-SCGs) and neuronavigation with Brainsight, to a novel SBB technique using Brainsight combined with a 3D-printed headframe (BS3D-HF) to improve the workflow of SBB in dogs. This was a prospective methods comparison with five canine cadavers of different breeds and size. Initial helical CT was performed on cadavers with fiducial markers in place. Ten different target points were randomly selected for each method. The headframe for the BS3D-HF was designed and printed. Trajectories were planned for each method. Steinmann pins (SPs) were placed into the target points using the planned trajectories for each method, and CT was repeated (post CT). Accuracy was assessed by overlaying the initial CT onto the post CT and measuring the difference of the planned target point to the SP placement. For 3D-SCG, the median deviation was 2.48 mm (0.64-4.04). With neuronavigation, the median deviation was 3.28 mm (1.04-4.64). For BS3D-HF, the median deviation was 14.8 mm (8.87-22.1). There was no significant difference between 3D-SCG and neuronavigation for the median deviation (p = 0.42). When comparing BS3D-HF to 3D-SCG, there was a significant difference in the median deviation (p < 0.0001). Additionally, when comparing BS3D-HF to neuronavigation, there was a significant difference for the median deviation (p < 0.0001). Our findings concluded that both 3D-SCGs and neuronavigation were accurate for SBB, however BS3D-HF was not. Although feasible, the current BS3D-HF technique requires further refinement before it can be recommended for use for SBB in dogs.
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Affiliation(s)
- Richard L. Shinn
- Clinical Applications Laboratory, Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Christopher Hollingsworth
- Clinical Applications Laboratory, Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Rell L. Parker
- Clinical Applications Laboratory, Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - John H. Rossmeisl
- Clinical Applications Laboratory, Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
- Department of Cancer Biology, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - Stephen R. Werre
- Department of Population Health Sciences, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
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Gutmann S, Heiderhoff M, Möbius R, Siegel T, Flegel T. Application accuracy of a frameless optical neuronavigation system as a guide for craniotomies in dogs. Acta Vet Scand 2023; 65:54. [PMID: 38098105 PMCID: PMC10722823 DOI: 10.1186/s13028-023-00720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Optical neuronavigation systems using infrared light to create a virtual reality image of the brain allow the surgeon to track instruments in real time. Due to the high vulnerability of the brain, neurosurgical interventions must be performed with a high precision. The aim of the experimental cadaveric study was to determine the application accuracy of a frameless optical neuronavigation system as guide for craniotomies by determining the target point deviation of predefined target points at the skull surface in the area of access to the cerebrum, cerebellum and the pituitary fossa. On each of the five canine cadaver heads ten target points were marked in a preoperative computed tomography (CT) scan. These target points were found on the cadaver skulls using the optical neuronavigation system. Then a small drill hole (1.5 mm) was drilled at these points. Subsequently, another CT scan was made. Both CT data sets were fused into the neuronavigation software, and the actual target point coordinates were identified. The target point deviation was determined as the difference between the planned and drilled target point coordinates. The calculated deviation was compared between two observers. RESULTS The analysis of the target point accuracies of all dogs in both observers taken together showed a median target point deviation of 1.57 mm (range: 0.42 to 5.14 mm). No significant differences were found between the observers or the different areas of target regions. CONCLUSION The application accuracy of the described system is similar to the accuracy of other optical neuronavigation systems previously described in veterinary medicine, in which mean values of 1.79 to 4.3 mm and median target point deviations of 0.79 to 3.53 mm were determined.
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Affiliation(s)
- Sarah Gutmann
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany.
| | - Miriam Heiderhoff
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany
| | - Robert Möbius
- Department of Neurosurgery, Faculty of Medicine, University Clinic of Leipzig, Leipzig, Germany
| | - Tanja Siegel
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany
| | - Thomas Flegel
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany
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Gutmann S, Tästensen C, Böttcher IC, Dietzel J, Loderstedt S, Kohl S, Matiasek K, Flegel T. Clinical use of a new frameless optical neuronavigation system for brain biopsies: 10 cases (2013-2020). J Small Anim Pract 2022; 63:468-481. [PMID: 35141897 DOI: 10.1111/jsap.13482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 11/09/2021] [Accepted: 01/18/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of the retrospective study was to describe the brain biopsy procedure using a new frameless optical neuronavigation system and to report diagnostic yield and complications associated with the procedure. MATERIALS AND METHODS The medical records for all dogs with forebrain lesions that underwent brain biopsy with a frameless optical neuronavigation system in a single referral hospital between 2013 and 2020 were retrospectively analysed. Following data were collected: signalment, neurological signs, diagnostic findings, number of brain biopsy samples, sampled region, complications, duration of hospitalisation, whether the samples were diagnostic and histopathological diagnoses. The device consists of a computer workstation with navigation software, an infrared camera, patient tracker and reflective instruments. The biopsy needle was equipped with reflective spheres, so the surgeon could see the position of the needle during sampling the intracranial lesion free handed through a mini-burr hole. RESULTS Ten dogs were included. Absolute diagnostic yield based on specific histopathological diagnosis was 73.9%. Three dogs had immune-mediated necrotizing encephalitis, two dogs showed a necrotizing leukoencephalitis and two dogs a meningoencephalitis of unknown origin. In two dogs, the brain specimen showed unspecific changes. In one dog, the samples were non-diagnostic. Seven dogs showed no neurological deterioration, one dog mild temporary ataxia and two dogs died within 36 hours post brain biopsy. CLINICAL SIGNIFICANCE In these 10 dogs, the frameless optical neuronavigation system employed was useful to gain diagnostic brain biopsy samples. Considering the mortality rate observed, further studies are needed to confirm the safety of this procedure and prove its actual clinical effectiveness.
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Affiliation(s)
- S Gutmann
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
| | - C Tästensen
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
| | - I C Böttcher
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
| | - J Dietzel
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
| | - S Loderstedt
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
| | - S Kohl
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
| | - K Matiasek
- Section of Clinical and Comparative Neuropathology, Ludwig-Maximilians-Universität, Munich, Germany
| | - T Flegel
- Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany
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Hunt JA, Simons MC, Anderson SL. If you build it, they will learn: A review of models in veterinary surgical education. Vet Surg 2021; 51:52-61. [PMID: 34270115 DOI: 10.1111/vsu.13683] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/28/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022]
Abstract
Surgical skills are learned through deliberate practice, and veterinary educators are increasingly turning to models for teaching and assessing surgical skills. This review article sought to compile and review the literature specific to veterinary surgical skills models, and to discuss the themes of fidelity, educational outcomes, and validity evidence. Several literature searches using broad terms such as "veterinary surgery model," "veterinary surgical model," and "veterinary surgical simulator" were performed using PubMed, CAB abstracts, and Google scholar. All articles describing a model created and utilized for veterinary surgical training were included. Other review articles were used as a source for additional models. Commercially available models were found using review articles, internet browser searches, and communication with veterinary clinical skills educators. There has been an explosion of growth in the variety of small animal surgical task trainers published in the last several decades. These models teach orthopedic surgery, ligation and suturing, open celiotomy and abdominal surgery, sterilization surgeries, and minimally invasive surgeries. Some models were published with accompanying rubrics for learner assessment; these rubrics have been noted where present. Research in veterinary surgical models is expanding and becoming an area of focus for academic institutions. However, there is room for growth in the collection of validity evidence and in development of models for teaching large animal surgery, training surgical residents, and providing continuing education to practitioners. This review can assist with evaluation of current surgical models and trends, and provide a platform for additional studies and development of best practices.
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Affiliation(s)
- Julie A Hunt
- Lincoln Memorial University College of Veterinary Medicine, Harrogate, Tennessee, USA
| | - Micha C Simons
- Lincoln Memorial University College of Veterinary Medicine, Harrogate, Tennessee, USA
| | - Stacy L Anderson
- Lincoln Memorial University College of Veterinary Medicine, Harrogate, Tennessee, USA
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Gutmann S, Winkler D, Müller M, Möbius R, Fischer JP, Böttcher P, Kiefer I, Grunert R, Flegel T. Accuracy of a magnetic resonance imaging-based 3D printed stereotactic brain biopsy device in dogs. J Vet Intern Med 2020; 34:844-851. [PMID: 32091636 PMCID: PMC7096628 DOI: 10.1111/jvim.15739] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/09/2020] [Accepted: 02/14/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Brain biopsy of intracranial lesions is often necessary to determine specific therapy. The cost of the currently used stereotactic rigid frame and optical tracking systems for brain biopsy in dogs is often prohibitive or accuracy is not sufficient for all types of lesion. OBJECTIVES To evaluate the application accuracy of an inexpensive magnetic resonance imaging-based personalized, 3D printed brain biopsy device. ANIMALS Twenty-two dog heads from cadavers were separated into 2 groups according to body weight (<15 kg, >20 kg). METHODS Experimental study. Two target points in each cadaver head were used (target point 1: caudate nucleus, target point 2: piriform lobe). Comparison between groups was performed using the independent Student's t test or the nonparametric Mann-Whitney U Test. RESULTS The total median target point deviation was 0.83 mm (range 0.09-2.76 mm). The separate median target point deviations for target points 1 and 2 in all dogs were 0.57 mm (range: 0.09-1.25 mm) and 0.85 mm (range: 0.14-2.76 mm), respectively. CONCLUSION AND CLINICAL IMPORTANCE This magnetic resonance imaging-based 3D printed stereotactic brain biopsy device achieved an application accuracy that was better than the accuracy of most brain biopsy systems that are currently used in veterinary medicine. The device can be applied to every size and shape of skull and allows precise positioning of brain biopsy needles in dogs.
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Affiliation(s)
- Sarah Gutmann
- Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Dirk Winkler
- Department of Neurosurgery, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Marcel Müller
- Medical Engineering, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
| | - Robert Möbius
- Department of Neurosurgery, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Jean-Pierre Fischer
- Department of Orthopedics, Trauma and Plastic Surgery, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Peter Böttcher
- Small Animal Clinic, Department of Veterinary Medicine, Free University of Berlin, Berlin, Germany
| | - Ingmar Kiefer
- Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Ronny Grunert
- Medical Engineering, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
| | - Thomas Flegel
- Department of Small Animal Medicine, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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Miller AD, Miller CR, Rossmeisl JH. Canine Primary Intracranial Cancer: A Clinicopathologic and Comparative Review of Glioma, Meningioma, and Choroid Plexus Tumors. Front Oncol 2019; 9:1151. [PMID: 31788444 PMCID: PMC6856054 DOI: 10.3389/fonc.2019.01151] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/16/2019] [Indexed: 12/22/2022] Open
Abstract
In the dog, primary intracranial neoplasia represents ~2-5% of all cancers and is especially common in certain breeds including English and French bulldogs and Boxers. The most common types of primary intracranial cancer in the dog are meningioma, glioma, and choroid plexus tumors, generally occurring in middle aged to older dogs. Much work has recently been done to understand the characteristic imaging and clinicopathologic features of these tumors. The gross and histologic landscape of these tumors in the dog compare favorably to their human counterparts with many similarities noted in histologic patterns, subtype, and grades. Data informing the underlying molecular abnormalities in the canine tumors have only begun to be unraveled, but reveal similar pathways are mutated between canine and human primary intracranial neoplasia. This review will provide an overview of the clinicopathologic features of the three most common forms of primary intracranial cancer in the dog, delve into the comparative aspects between the dog and human neoplasms, and provide an introduction to current standard of care while also highlighting novel, experimental treatments that may help bridge the gap between canine and human cancer therapies.
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Affiliation(s)
- Andrew D. Miller
- Section of Anatomic Pathology, Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - C. Ryan Miller
- Division of Neuropathology, Department of Pathology, O'Neal Comprehensive Cancer Center and Comprehensive Neuroscience Center, University of Alabama School of Medicine, Birmingham, AL, United States
| | - John H. Rossmeisl
- Section of Neurology and Neurosurgery, Veterinary and Comparative Neuro-Oncology Laboratory, Department of Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
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Phillips H, Maxwell EA, Schaeffer DJ, Fan TM. Simulation of spatial diffusion of platinum from carboplatin-impregnated calcium sulfate hemihydrate beads by use of an agarose gelatin tissue phantom. Am J Vet Res 2018; 79:592-599. [DOI: 10.2460/ajvr.79.6.592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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