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Matsumae M, Nishiyama J, Kuroda K. Intraoperative MR Imaging during Glioma Resection. Magn Reson Med Sci 2022; 21:148-167. [PMID: 34880193 PMCID: PMC9199972 DOI: 10.2463/mrms.rev.2021-0116] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/11/2021] [Indexed: 11/09/2022] Open
Abstract
One of the major issues in the surgical treatment of gliomas is the concern about maximizing the extent of resection while minimizing neurological impairment. Thus, surgical planning by carefully observing the relationship between the glioma infiltration area and eloquent area of the connecting fibers is crucial. Neurosurgeons usually detect an eloquent area by functional MRI and identify a connecting fiber by diffusion tensor imaging. However, during surgery, the accuracy of neuronavigation can be decreased due to brain shift, but the positional information may be updated by intraoperative MRI and the next steps can be planned accordingly. In addition, various intraoperative modalities may be used to guide surgery, including neurophysiological monitoring that provides real-time information (e.g., awake surgery, motor-evoked potentials, and sensory evoked potential); photodynamic diagnosis, which can identify high-grade glioma cells; and other imaging techniques that provide anatomical information during the surgery. In this review, we present the historical and current context of the intraoperative MRI and some related approaches for an audience active in the technical, clinical, and research areas of radiology, as well as mention important aspects regarding safety and types of devices.
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Affiliation(s)
- Mitsunori Matsumae
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Jun Nishiyama
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kagayaki Kuroda
- Department of Human and Information Sciences, School of Information Science and Technology, Tokai University, Hiratsuka, Kanagawa, Japan
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Wang J, Lv Y, Wang J, Ma F, Du Y, Fan X, Wang M, Ke J. Fully automated segmentation in temporal bone CT with neural network: a preliminary assessment study. BMC Med Imaging 2021; 21:166. [PMID: 34753454 PMCID: PMC8576911 DOI: 10.1186/s12880-021-00698-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/26/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Segmentation of important structures in temporal bone CT is the basis of image-guided otologic surgery. Manual segmentation of temporal bone CT is time- consuming and laborious. We assessed the feasibility and generalization ability of a proposed deep learning model for automated segmentation of critical structures in temporal bone CT scans. METHODS Thirty-nine temporal bone CT volumes including 58 ears were divided into normal (n = 20) and abnormal groups (n = 38). Ossicular chain disruption (n = 10), facial nerve covering vestibular window (n = 10), and Mondini dysplasia (n = 18) were included in abnormal group. All facial nerves, auditory ossicles, and labyrinths of the normal group were manually segmented. For the abnormal group, aberrant structures were manually segmented. Temporal bone CT data were imported into the network in unmarked form. The Dice coefficient (DC) and average symmetric surface distance (ASSD) were used to evaluate the accuracy of automatic segmentation. RESULTS In the normal group, the mean values of DC and ASSD were respectively 0.703, and 0.250 mm for the facial nerve; 0.910, and 0.081 mm for the labyrinth; and 0.855, and 0.107 mm for the ossicles. In the abnormal group, the mean values of DC and ASSD were respectively 0.506, and 1.049 mm for the malformed facial nerve; 0.775, and 0.298 mm for the deformed labyrinth; and 0.698, and 1.385 mm for the aberrant ossicles. CONCLUSIONS The proposed model has good generalization ability, which highlights the promise of this approach for otologist education, disease diagnosis, and preoperative planning for image-guided otology surgery.
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Affiliation(s)
- Jiang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Peking University, NO. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yi Lv
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Junchen Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Furong Ma
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Peking University, NO. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yali Du
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Peking University, NO. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xin Fan
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Peking University, NO. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Menglin Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Peking University, NO. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Jia Ke
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University Third Hospital, Peking University, NO. 49 North Garden Road, Haidian District, Beijing, 100191, China.
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Reinertsen I, Collins DL, Drouin S. The Essential Role of Open Data and Software for the Future of Ultrasound-Based Neuronavigation. Front Oncol 2021; 10:619274. [PMID: 33604299 PMCID: PMC7884817 DOI: 10.3389/fonc.2020.619274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/11/2020] [Indexed: 01/17/2023] Open
Abstract
With the recent developments in machine learning and modern graphics processing units (GPUs), there is a marked shift in the way intra-operative ultrasound (iUS) images can be processed and presented during surgery. Real-time processing of images to highlight important anatomical structures combined with in-situ display, has the potential to greatly facilitate the acquisition and interpretation of iUS images when guiding an operation. In order to take full advantage of the recent advances in machine learning, large amounts of high-quality annotated training data are necessary to develop and validate the algorithms. To ensure efficient collection of a sufficient number of patient images and external validity of the models, training data should be collected at several centers by different neurosurgeons, and stored in a standard format directly compatible with the most commonly used machine learning toolkits and libraries. In this paper, we argue that such effort to collect and organize large-scale multi-center datasets should be based on common open source software and databases. We first describe the development of existing open-source ultrasound based neuronavigation systems and how these systems have contributed to enhanced neurosurgical guidance over the last 15 years. We review the impact of the large number of projects worldwide that have benefited from the publicly available datasets “Brain Images of Tumors for Evaluation” (BITE) and “Retrospective evaluation of Cerebral Tumors” (RESECT) that include MR and US data from brain tumor cases. We also describe the need for continuous data collection and how this effort can be organized through the use of a well-adapted and user-friendly open-source software platform that integrates both continually improved guidance and automated data collection functionalities.
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Affiliation(s)
- Ingerid Reinertsen
- Department of Health Research, SINTEF Digital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - D Louis Collins
- NIST Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montréal, QC, Canada
| | - Simon Drouin
- Laboratoire Multimédia, École de Technologie Supérieure, Montréal, QC, Canada
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Canalini L, Klein J, Miller D, Kikinis R. Enhanced registration of ultrasound volumes by segmentation of resection cavity in neurosurgical procedures. Int J Comput Assist Radiol Surg 2020; 15:1963-1974. [PMID: 33029677 PMCID: PMC7671994 DOI: 10.1007/s11548-020-02273-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 09/25/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Neurosurgeons can have a better understanding of surgical procedures by comparing ultrasound images obtained at different phases of the tumor resection. However, establishing a direct mapping between subsequent acquisitions is challenging due to the anatomical changes happening during surgery. We propose here a method to improve the registration of ultrasound volumes, by excluding the resection cavity from the registration process. METHODS The first step of our approach includes the automatic segmentation of the resection cavities in ultrasound volumes, acquired during and after resection. We used a convolution neural network inspired by the 3D U-Net. Then, subsequent ultrasound volumes are registered by excluding the contribution of resection cavity. RESULTS Regarding the segmentation of the resection cavity, the proposed method achieved a mean DICE index of 0.84 on 27 volumes. Concerning the registration of the subsequent ultrasound acquisitions, we reduced the mTRE of the volumes acquired before and during resection from 3.49 to 1.22 mm. For the set of volumes acquired before and after removal, the mTRE improved from 3.55 to 1.21 mm. CONCLUSIONS We proposed an innovative registration algorithm to compensate the brain shift affecting ultrasound volumes obtained at subsequent phases of neurosurgical procedures. To the best of our knowledge, our method is the first to exclude automatically segmented resection cavities in the registration of ultrasound volumes in neurosurgery.
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Affiliation(s)
- Luca Canalini
- Fraunhofer MEVIS, Institute for Digital Medicine, Bremen, Germany.
- Medical Imaging Computing, University of Bremen, Bremen, Germany.
| | - Jan Klein
- Fraunhofer MEVIS, Institute for Digital Medicine, Bremen, Germany
| | - Dorothea Miller
- Department of Neurosurgery, University Hospital Knappschaftskrankenhaus, Bochum, Germany
| | - Ron Kikinis
- Surgical Planning Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
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