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Manso Jimeno M, Vaughan JT, Geethanath S. Superconducting magnet designs and MRI accessibility: A review. NMR IN BIOMEDICINE 2023:e4921. [PMID: 36914280 DOI: 10.1002/nbm.4921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Presently, magnetic resonance imaging (MRI) magnets must deliver excellent magnetic field (B0 ) uniformity to achieve optimum image quality. Long magnets can satisfy the homogeneity requirements but require considerable superconducting material. These designs result in large, heavy, and costly systems that aggravate as field strength increases. Furthermore, the tight temperature tolerance of niobium titanium magnets adds instability to the system and requires operation at liquid helium temperature. These issues are crucial factors in the disparity of MR density and field strength use across the globe. Low-income settings show reduced access to MRI, especially to high field strengths. This article summarizes the proposed modifications to MRI superconducting magnet design and their impact on accessibility, including compact, reduced liquid helium, and specialty systems. Reducing the amount of superconductor inevitably entails shrinking the magnet size, resulting in higher field inhomogeneity. This work also reviews the state-of-the-art imaging and reconstruction methods to overcome this issue. Finally, we summarize the current and future challenges and opportunities in the design of accessible MRI.
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Affiliation(s)
- Marina Manso Jimeno
- Department of Biomedical Engineering, Columbia University in the City of New York, New York, New York, USA
- Columbia Magnetic Resonance Research Center, Columbia University in the City of New York, New York, New York, USA
| | - John Thomas Vaughan
- Department of Biomedical Engineering, Columbia University in the City of New York, New York, New York, USA
- Columbia Magnetic Resonance Research Center, Columbia University in the City of New York, New York, New York, USA
| | - Sairam Geethanath
- Columbia Magnetic Resonance Research Center, Columbia University in the City of New York, New York, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, The Biomedical Engineering and Imaging Institute, New York, New York, USA
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Yaras YS, Yildirim DK, Herzka DA, Rogers T, Campbell-Washburn AE, Lederman RJ, Degertekin FL, Kocaturk O. Real-time device tracking under MRI using an acousto-optic active marker. Magn Reson Med 2020; 85:2904-2914. [PMID: 33347642 DOI: 10.1002/mrm.28625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/30/2020] [Accepted: 11/09/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This work aims to demonstrate the use of an "active" acousto-optic marker with enhanced visibility and reduced radiofrequency (RF) -induced heating for interventional MRI. METHODS The acousto-optic marker was fabricated using bulk piezoelectric crystal and π-phase shifted fiber Bragg grating (FBGs) and coupled to a distal receiver coil on an 8F catheter. The received MR signal is transmitted over an optical fiber to mitigate RF-induced heating. A photodetector converts the optical signal into electrical signal, which is used as the input signal to the MRI receiver plug. Acousto-optic markers were characterized in phantom studies. RF-induced heating risk was evaluated according to ASTM 2182 standard. In vivo real-time tracking capability was tested in an animal model under a 0.55T scanner. RESULTS Signal-to-noise ratio (SNR) levels suitable for real-time tracking were obtained by using high sensitivity FBG and piezoelectric transducer with resonance matched to Larmor frequency. Single and multiple marker coils integrated to 8F catheters were readout for position and orientation tracking by a single acousto-optic sensor. RF-induced heating was significantly reduced compared to a coax cable connected reference marker. Real-time distal tip tracking of an active device was demonstrated in an animal model with a standard real-time cardiac MR sequence. CONCLUSION Acousto-optic markers provide sufficient SNR with a simple structure for real-time device tracking. RF-induced heating is significantly reduced compared to conventional active markers. Also, multiple RF receiver coils connected on an acousto-optic modulator can be used on a single catheter for determining catheter orientation and shape.
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Affiliation(s)
- Yusuf S Yaras
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Micromachined Sensors and Transducers Group, Atlanta, Georgia, USA
| | - Dursun Korel Yildirim
- National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Daniel A Herzka
- National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Toby Rogers
- National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | | | - Robert J Lederman
- National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - F Levent Degertekin
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Micromachined Sensors and Transducers Group, Atlanta, Georgia, USA
| | - Ozgur Kocaturk
- Institute of Biomedical Engineering, Bogazici University, Kandilli Kampus, Istanbul, Turkey
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Azmi H, Gibbons M, DeVito MC, Schlesinger M, Kreitner J, Freguletti T, Banovic J, Ferrell D, Horton M, Pierce S, Roth P. The interventional magnetic resonance imaging suite: Experience in the design, development, and implementation in a pre-existing radiology space and review of concepts. Surg Neurol Int 2019; 10:101. [PMID: 31528439 PMCID: PMC6744761 DOI: 10.25259/sni-209-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/29/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Intraoperative magnetic resonance imaging (ioMRI) has led to significant advancements in neurosurgery with improved accuracy, assessment of the extent of resection, less invasive surgical alternatives, and real-time confirmation of targeting as well delivery of therapies. The costs associated with developing ioMRI units in the surgical suite have been obstacles to the expansion of their use. More recently, the development of hybrid interventional MRI (iMRI) units has become a viable alternative. The process of designing, developing, and implementing operations for these units requires the careful integration of environmental, technical, and safety elements of both surgical and MR practices. There is a paucity of published literature providing guidance for institutions looking to develop a hybrid iMRI unit, especially with a limited footprint in the radiology department. METHODS The experience of designing, developing, and implementing an iMRI in a preexisting space for neurosurgical procedures at a single institution in light of available options and the literature is described. RESULTS The development of the unit was accomplished through the engagement of a multidisciplinary team of stakeholders who utilized existing guidelines and recommendations and their own professional experience to address issues including physical layout, equipment selection, operations planning, infection control, and oversight/review, among others. CONCLUSION Successful creation of an iMRI program requires multidisciplinary collaboration in integrating surgical and MR practice. The authors' aim is that the experience described in this article will serve as an example for facilities or neurosurgical departments looking to navigate the same process.
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Affiliation(s)
- Hooman Azmi
- Departments of Neurosurgery, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Mary Gibbons
- Departments of Radiology, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Michele C. DeVito
- Departments of Radiology, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Mark Schlesinger
- Departments of Anesthesiology, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Jason Kreitner
- Departments of Operations, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Terri Freguletti
- Departments of Perioperative Services, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Joan Banovic
- Departments of Perioperative Services, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Donald Ferrell
- Departments of Operations, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Michael Horton
- Departments of Radiology, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Sean Pierce
- Departments of Radiology, Hackensack University Medical Center, Hackensack, New Jersey, United States
| | - Patrick Roth
- Departments of Neurosurgery, Hackensack University Medical Center, Hackensack, New Jersey, United States
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Sorokin A, Zhvansky E, Shurkhay V, Bocharov K, Popov I, Levin N, Zubtsov D, Bormotov D, Kostyukevich Y, Potapov A, Nikolaev E. Feature selection algorithm for spray-from-tissue mass spectrometry. EUROPEAN JOURNAL OF MASS SPECTROMETRY (CHICHESTER, ENGLAND) 2017; 23:237-241. [PMID: 29028388 DOI: 10.1177/1469066717721843] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Detection of the brain tumor margins is one of the most significant problems in neurosurgery. Several mass spectrometry-based approaches have been proposed recently for tumor boundary detection. One of them, spray from tissue does not require sample preparation but needs special algorithms for analysis of its spectra. Here we proposed the feature selection algorithm designed for analysis of spray-from-tissue data.
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Affiliation(s)
- Anatoly Sorokin
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
| | - Evgeny Zhvansky
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
- 2 Institute for Energy Problems of Chemical Physics of the Russian Academy of Sciences, Moscow, Russia
| | - Vsevolod Shurkhay
- 3 Federal State Autonomous Institution "N.N. Burdenko National Scientific and Practical Center for Neurosurgery" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Konstantin Bocharov
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
- 2 Institute for Energy Problems of Chemical Physics of the Russian Academy of Sciences, Moscow, Russia
| | - Igor Popov
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
- 4 Emanuel Institute for Biochemical Physics of the Russian Academy of Sciences, Moscow, Russia
| | - Nikita Levin
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
| | - Dmitry Zubtsov
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
| | - Denis Bormotov
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
| | - Yury Kostyukevich
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
- 2 Institute for Energy Problems of Chemical Physics of the Russian Academy of Sciences, Moscow, Russia
| | - Alexander Potapov
- 3 Federal State Autonomous Institution "N.N. Burdenko National Scientific and Practical Center for Neurosurgery" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Eugene Nikolaev
- 1 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia
- 2 Institute for Energy Problems of Chemical Physics of the Russian Academy of Sciences, Moscow, Russia
- 4 Emanuel Institute for Biochemical Physics of the Russian Academy of Sciences, Moscow, Russia
- 5 Skolkovo Institute of Science and Technology, Skolkovo, Russia
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Himes NC, Chansakul T, Lee TC. Magnetic Resonance Imaging-Guided Spine Interventions. Magn Reson Imaging Clin N Am 2015; 23:523-32. [PMID: 26499272 DOI: 10.1016/j.mric.2015.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
MR imaging-guided interventions for treatment of low back pain and for diagnosis and treatment of soft tissue and bony spinal lesions have been shown to be feasible, effective, and safe. Advantages of this technique include the absence of ionizing radiation, the high tissue contrast, and multiplanar imaging options. Recent advancements in MR imaging systems allow improved image qualities and real-time guidance. One exciting application is MR imaging-guided cryotherapy of spinal lesions, including treating such lesions as benign osteoid osteomas and malignant metastatic disease in patients who are not good surgical candidates. This particular technique shows promise for local tumor control and pain relief in appropriate patients.
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Affiliation(s)
- Nathan C Himes
- Division of Neuroradiology, Brigham and Women's Hospital, 75 Francis Street, PBB-339, Boston, MA 02115, USA
| | - Thanissara Chansakul
- Division of Neuroradiology, Brigham and Women's Hospital, 75 Francis Street, PBB-339, Boston, MA 02115, USA
| | - Thomas C Lee
- Division of Neuroradiology, Brigham and Women's Hospital, 75 Francis Street, PBB-339, Boston, MA 02115, USA.
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Calligaris D, Norton I, Feldman DR, Ide JL, Dunn IF, Eberlin LS, Cooks RG, Jolesz FA, Golby AJ, Santagata S, Agar NY. Mass spectrometry imaging as a tool for surgical decision-making. JOURNAL OF MASS SPECTROMETRY : JMS 2013; 48:1178-87. [PMID: 24259206 PMCID: PMC3957233 DOI: 10.1002/jms.3295] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/03/2013] [Accepted: 10/10/2013] [Indexed: 05/18/2023]
Abstract
Despite significant advances in image-guided therapy, surgeons are still too often left with uncertainty when deciding to remove tissue. This binary decision between removing and leaving tissue during surgery implies that the surgeon should be able to distinguish tumor from healthy tissue. In neurosurgery, current image-guidance approaches such as magnetic resonance imaging (MRI) combined with neuronavigation offer a map as to where the tumor should be, but the only definitive method to characterize the tissue at stake is histopathology. Although extremely valuable information is derived from this gold standard approach, it is limited to very few samples during surgery and is not practically used for the delineation of tumor margins. The development and implementation of faster, comprehensive, and complementary approaches for tissue characterization are required to support surgical decision-making--an incremental and iterative process with tumor removed in multiple and often minute biopsies. The development of atmospheric pressure ionization sources makes it possible to analyze tissue specimens with little to no sample preparation. Here, we highlight the value of desorption electrospray ionization as one of many available approaches for the analysis of surgical tissue. Twelve surgical samples resected from a patient during surgery were analyzed and diagnosed as glioblastoma tumor or necrotic tissue by standard histopathology, and mass spectrometry results were further correlated to histopathology for critical validation of the approach. The use of a robust statistical approach reiterated results from the qualitative detection of potential biomarkers of these tissue types. The correlation of the mass spectrometry and histopathology results to MRI brings significant insight into tumor presentation that could not only serve to guide tumor resection, but that is also worthy of more detailed studies on our understanding of tumor presentation on MRI.
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Affiliation(s)
- David Calligaris
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Isaiah Norton
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Daniel R. Feldman
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Jennifer L. Ide
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Ian F. Dunn
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Livia S. Eberlin
- Department of Chemistry and Center for Analytical Instrumentation Development, Purdue University, West Lafayette, IN 47907
| | - R. Graham Cooks
- Department of Chemistry and Center for Analytical Instrumentation Development, Purdue University, West Lafayette, IN 47907
| | - Ferenc A. Jolesz
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Alexandra J. Golby
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Sandro Santagata
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Nathalie Y. Agar
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
- Department of Chemistry and Center for Analytical Instrumentation Development, Purdue University, West Lafayette, IN 47907
- Corresponding author: Dr. Nathalie Y.R. Agar Departments of Neurosurgery and Radiology, Brigham and Women’s Hospital, and Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115. , +1617/525-7374
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8
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Eberlin LS, Norton I, Dill AL, Golby AJ, Ligon KL, Santagata S, Cooks RG, Agar NYR. Classifying human brain tumors by lipid imaging with mass spectrometry. Cancer Res 2011; 72:645-54. [PMID: 22139378 DOI: 10.1158/0008-5472.can-11-2465] [Citation(s) in RCA: 228] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brain tissue biopsies are required to histologically diagnose brain tumors, but current approaches are limited by tissue characterization at the time of surgery. Emerging technologies such as mass spectrometry imaging can enable a rapid direct analysis of cancerous tissue based on molecular composition. Here, we illustrate how gliomas can be rapidly classified by desorption electrospray ionization-mass spectrometry (DESI-MS) imaging, multivariate statistical analysis, and machine learning. DESI-MS imaging was carried out on 36 human glioma samples, including oligodendroglioma, astrocytoma, and oligoastrocytoma, all of different histologic grades and varied tumor cell concentration. Gray and white matter from glial tumors were readily discriminated and detailed diagnostic information could be provided. Classifiers for subtype, grade, and concentration features generated with lipidomic data showed high recognition capability with more than 97% cross-validation. Specimen classification in an independent validation set agreed with expert histopathology diagnosis for 79% of tested features. Together, our findings offer proof of concept that intraoperative examination and classification of brain tissue by mass spectrometry can provide surgeons, pathologists, and oncologists with critical and previously unavailable information to rapidly guide surgical resections that can improve management of patients with malignant brain tumors.
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Affiliation(s)
- Livia S Eberlin
- Department of Chemistry and Center for Analytical Instrumentation Development, Purdue University, West Lafayette, Indiana 47907, USA
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9
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While PT, Forbes LK, Crozier S. 3D gradient coil design for open MRI systems. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2010; 207:124-133. [PMID: 20850360 DOI: 10.1016/j.jmr.2010.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 08/17/2010] [Accepted: 08/23/2010] [Indexed: 05/29/2023]
Abstract
Existing gradient coil design methods typically require some predetermined surface to be specified upon which the precise locations of coil windings are optimised with respect to gradient homogeneity and other measures of coil performance. In contrast, in this paper an analytic inverse method is presented for the theoretical design of 3D gradient coils in which the precise 3D geometry of the coils is obtained as part of the optimisation process. This method has been described previously for cylindrical whole-body gradients and is extended here for open MRI systems. A 3D current density solution is obtained using Fourier series combined with Tikhonov regularisation. The examples presented involve a minimum power penalty function and an optional shielding constraint. A discretised set of 3D coil windings is obtained using an equi-flux streamline seeding method. Results for an unshielded example display a concentration of windings within the portion of the coil volume nearest the imaging region and looped return path windings taken away from this region. However, for a shielded example the coil windings are found to lie almost exclusively on biplanar surfaces, suggesting that this is the optimum geometry for a shielded minimum power open coil.
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Affiliation(s)
- Peter T While
- School of Mathematics & Physics, University of Tasmania, Private Bag 37, Hobart, Tasmania 7001, Australia.
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Sansone M, Mirarchi L, Bracale M. Adaptive removal of gradients-induced artefacts on ECG in MRI: a performance analysis of RLS filtering. Med Biol Eng Comput 2010; 48:475-82. [PMID: 20238253 DOI: 10.1007/s11517-010-0596-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 02/26/2010] [Indexed: 10/19/2022]
Abstract
One of the main vital signs used in patient monitoring during Magnetic Resonance Imaging (MRI) is Electro-Cardio-Gram (ECG). Unfortunately, magnetic fields gradients induce artefacts which severely affect ECG quality. Adaptive Noise Cancelling (ANC) is one of the preferred techniques for artefact removal. ANC involves the adaptive estimation of the impulse response of the system constituted by the MRI equipment, the patient and the ECG recording device. Least Mean Square (LMS) adaptive filtering has been traditionally employed because of its simplicity: anyway, it requires the choice of a step-size parameter, whose proper value for the specific application must be estimated case by case: an improper choice could yield slow convergence and unsatisfactory behaviour. Recursive Least Square (RLS) algorithm has, potentially, faster convergence while not requiring any parameter. As far as the authors' knowledge, there is no systematic analysis of performances of RLS in this scenario. In this study we evaluated the performance of RLS for adaptive removal of artefacts induced by magnetic field gradients on ECG in MRI, in terms of efficacy of suppression. Tests have been made on real signals, acquired via an expressly developed system. A comparison with LMS was made on the basis of opportune performance indices. Results indicate that RLS is superior to LMS in several respects.
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Affiliation(s)
- Mario Sansone
- Department of Biomedical, Electronic and Telecommunications Engineering, University Federico II of Naples, via Claudio 21, 80131, Naples, Italy.
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Kalogeropoulou C, Kallidonis P, Liatsikos EN. Imaging in percutaneous nephrolithotomy. J Endourol 2009; 23:1571-7. [PMID: 19630501 DOI: 10.1089/end.2009.1521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Image guidance is a critical factor for the performance of urologic interventions. Percutaneous minimally invasive procedures have been developed and are being used with constantly increasing frequency. Procedures such as percutaneous nephrolithotomy (PCNL) are not performed without any image guidance. Recent developments in medical imaging, such as three-dimensional radiographic fluoroscopy, CT, and magnetic resonance (MR) fluoroscopy, four-dimensional ultrasonography, and image fusion techniques, propose a new generation of image-guidance tools that promise to improve patient care. These developments have been used or have the potential to be used in PCNL and other urologic interventional procedures. Moreover, advanced needles and needle guidance systems provide a new perspective for the nephrolithotomy suite of the future. The current review presents existing imaging technology in PCNL and interventional urology as well as advanced imaging techniques that are being or are expected to be evaluated in PCNL practice.
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Kettenbach J, Kacher DF, Kanan AR, Rostenberg B, Fairhurst J, Stadler A, Kienreich K, Jolesz FA. Intraoperative and interventional MRI: Recommendations for a safe environment. MINIM INVASIV THER 2009; 15:53-64. [PMID: 16754187 DOI: 10.1080/13645700600640774] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this paper we report on current experience and review magnetic resonance safety protocols and literature in order to define practices surrounding MRI-guided interventional and surgical procedures. Direct experience, the American College of Radiology White paper on MR Safety, and various other sources are summarized. Additional recommendations for interventional and surgical MRI-guided procedures cover suite location/layout, accessibility, safety policy, personnel training, and MRI compatibility issues. Further information is freely available for sites to establish practices to minimize risk and ensure safety. Interventional and intraoperative MRI is emerging from its infancy, with twelve years since the advent of the field and well over 10,000 cases collectively performed. Thus, users of interventional and intraoperative MRI should adapt guidelines utilizing universal standards and terminology and establish a site-specific policy. With policy enforcement and proper training, the interventional and intraoperative MR imaging suite can be a safe and effective environment.
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Affiliation(s)
- Joachim Kettenbach
- Department of Radiology, Medical University Vienna, General Hospital, Vienna, Austria.
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Elhawary H, Zivanovic A, Rea M, Davies BL, Besant C, McRobbie D, Desouza NM, Young I, Lamperth MU. A modular approach to MRI-compatible robotics: using robotic modules with interconnectable 1-DoF Stages. ACTA ACUST UNITED AC 2008; 27:35-41. [PMID: 18519180 DOI: 10.1109/emb.2007.910260] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Haytham Elhawary
- Mechanical and Medicine Laboratory, Imperial College, London, UK
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Weiss CR, Nour SG, Lewin JS. MR-guided biopsy: a review of current techniques and applications. J Magn Reson Imaging 2008; 27:311-25. [PMID: 18219685 DOI: 10.1002/jmri.21270] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Biopsy has become a cornerstone of modern medicine and most modern biopsies are performed percutaneously using image guidance, typically computed tomography or ultrasound. MR-guided biopsy offers many advantages over these more traditional modalities, and the recent development of interventional MR imaging techniques has made MR-guided percutaneous biopsies and aspirations a clinical reality. As the field of MR-guided procedures continues to expand and to attract more attention from radiologists, it is important to understand the concepts, techniques, applications, advantages, and limitations of MR-guided biopsy/percutaneous procedures. Radiologists should also recognize the need for their significant involvement in the technical aspects of MR-guided procedures, since several user-defined parameters can alter device visualization in the MR imaging environment and affect procedure safety. This article reviews the prerequisites, systems, and applications of MR-guided biopsy.
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Affiliation(s)
- Clifford R Weiss
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Scalise L, Morbiducci U. Non-contact cardiac monitoring from carotid artery using optical vibrocardiography. Med Eng Phys 2008; 30:490-7. [PMID: 17625946 DOI: 10.1016/j.medengphy.2007.05.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 05/14/2007] [Accepted: 05/18/2007] [Indexed: 11/23/2022]
Abstract
The aim of the present work is to establish a protocol for monitoring the cardiac activity measuring the skin surface vibrations of the main neck vessels, caused by vascular wall motion in carotid artery. The method is based on the optical recording of the movements of the neck by means of laser Doppler interferometry. The ECG signal and the velocity of vibration of the skin in correspondence of the carotid artery (named optical vibrocardiography: VCG) have been simultaneously recorded on five healthy subjects. Standard heart rate variability tests have been carried out. The capability of VCG signals to be used as a surrogate of the ECG in assessing both cardiac rate and heart rate variability (HRV) has been tested using time and spectral descriptors, and specific statistical analysis. Mean differences have been found lower than 3.13%. Optical vibrocardiography might be a simple approach to the clinical practice of cardiovascular screening, in particular in harsh environment, such as MR clinical practice, where ECG recordings are corrupted by artefacts and ECG cables might represent an hazard for the patients.
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Affiliation(s)
- Lorenzo Scalise
- Department of Mechanics, Università Politecnica delle Marche, Via Brecce Bianche, 60122 Ancona, Italy.
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Tatli S, Morrison PR, Tuncali K, Silverman SG. Interventional MRI for Oncologic Applications. Tech Vasc Interv Radiol 2007; 10:159-70. [DOI: 10.1053/j.tvir.2007.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Hendee WR, Banovac F, Carson PL, DeFronzo RA, Eckelman WC, Fullerton GD, Larson SM, McLennan G, Welch MJ. Biomedical imaging research opportunities workshop IV: a white paper. Med Phys 2007; 34:673-9. [PMID: 17388185 DOI: 10.1118/1.2405838] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The Fourth Biomedical Imaging Research Opportunities Workshop (BIROW IV) was held on February 24-25, 2006, in North Bethesda, MD. The workshop focused on opportunities for research and development in four areas of imaging: imaging of rodent models; imaging in drug development; imaging of chronic metabolic disease: diabetes; and image guided intervention in the fourth dimension-time. These topics were examined by four keynote speakers in plenary sessions and then discussed in breakout sessions devoted to identifying research opportunities and challenges in the individual topics. This paper synthesizes these discussions into a strategy for future research directions in biomedical imaging.
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Affiliation(s)
- William R Hendee
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, Wisconsin 53226, USA.
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Birkfellner W, Figl M, Kettenbach J, Hummel J, Homolka P, Schernthaner R, Nau T, Bergmann H. Rigid 2D/3D slice-to-volume registration and its application on fluoroscopic CT images. Med Phys 2007; 34:246-55. [PMID: 17278510 DOI: 10.1118/1.2401661] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Registration of single slices from FluoroCT, CineMR, or interventional magnetic resonance imaging to three dimensional (3D) volumes is a special aspect of the two-dimensional (2D)/3D registration problem. Rather than digitally rendered radiographs (DRR), single 2D slice images obtained during interventional procedures are compared to oblique reformatted slices from a high resolution 3D scan. Due to the lack of perspective information and the different imaging geometry, convergence behavior differs significantly from 2D/3D registration applications comparing DRR images with conventional x-ray images. We have implemented a number of merit functions and local and global optimization algorithms for slice-to-volume registration of computed tomography (CT) and FluoroCT images. These methods were tested on phantom images derived from clinical scans for liver biopsies. Our results indicate that good registration accuracy in the range of 0.50 and 1.0 mm is achievable using simple cross correlation and repeated application of local optimization algorithms. Typically, a registration took approximately 1 min on a standard personal computer. Other merit functions such as pattern intensity or normalized mutual information did not perform as well as cross correlation in this initial evaluation. Furthermore, it appears as if the use of global optimization algorithms such as simulated annealing does not improve reliability or accuracy of the registration process. These findings were also confirmed in a preliminary registration study on five clinical scans. These experiments have, however, shown that a strict breath-hold protocol is inevitable when using rigid registration techniques for lesion localization in image-guided biopsy retrieval. Finally, further possible applications of slice-to-volume registration are discussed.
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Affiliation(s)
- Wolfgang Birkfellner
- Center for Biomedical Engineering and Physics, Medical University Vienna, Vienna A-1090, Austria.
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20
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Morbiducci U, Scalise L, De Melis M, Grigioni M. Optical Vibrocardiography: A Novel Tool for the Optical Monitoring of Cardiac Activity. Ann Biomed Eng 2006; 35:45-58. [PMID: 17082980 DOI: 10.1007/s10439-006-9202-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Accepted: 09/11/2006] [Indexed: 01/09/2023]
Abstract
We present an optical non-contact method for heart beat monitoring, based on the measurement of chest wall movements induced by the pumping action of the heart, which is eligible as a surrogate of electrocardiogram (ECG) in assessing both cardiac rate and heart rate variability (HRV). The method is based on the optical recording of the movements of the chest wall by means of laser Doppler interferometry. To this aim, the ECG signal and the velocity of vibration of the chest wall, named optical vibrocardiography (VCG), were simultaneously recorded on 10 subjects. The time series built from the sequences of consecutive R waves (on ECG) and vibrocardiographic (VV) intervals were compared in terms of heart rate (HR). To evaluate the ability of VCG signals as quantitative marker of the autonomic activity, HRV descriptors were also calculated on both ECG and VCG time series. HR and HRV indices obtained from the proposed method agreed with the rate derived from ECG recordings (mean percent difference <3.1%). Our comparison concludes that optical VCG provides a reliable assessment of HR and HRV analysis, with no statistical differences in term of gender are present. Optical VCG appears promising as non-contact method to monitor the cardiac activity under specific conditions, e.g., in magnetic resonance environment, or to reduce exposure risks to workers subjected to hazardous conditions. The technique may be used also to monitor subjects, e.g., severely burned, for which contact with the skin needs to be minimized.
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Affiliation(s)
- Umberto Morbiducci
- Department of Mechanics, Università Politecnica delle Marche, Via Brecce Bianche, 60100 Ancona, Italy
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21
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Blanco RT, Ojala R, Kariniemi J, Perälä J, Niinimäki J, Tervonen O. Interventional and intraoperative MRI at low field scanner--a review. Eur J Radiol 2006; 56:130-42. [PMID: 15908156 DOI: 10.1016/j.ejrad.2005.03.033] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2005] [Revised: 03/05/2005] [Accepted: 03/08/2005] [Indexed: 02/07/2023]
Abstract
Magnetic resonance imaging (MRI) is a cutting edge imaging modality in detecting diseases and pathologic tissue. The superior soft tissue contrast in MRI allows better definition of the pathology. MRI is increasingly used for guiding, monitoring and controlling percutaneous procedures and surgery. The rapid development of interventional techniques in radiology has led to integration of imaging with computers, new therapy devices and operating room like conditions. This has projected as faster and more accurate imaging and hence more demanding procedures have been applied to the repertoire of the interventional radiologist. In combining features of various other imaging modalities and adding some more into them, interventional MRI (IMRI) has potential to take further the interventional radiology techniques, minimally invasive therapies and surgery. The term "Interventional MRI" consists in short all those procedures, which are performed under MRI guidance. These procedures can be either percutaneous or open surgical of nature. One of the limiting factors in implementing MRI as guidance modality for interventional procedures has been the fact, that most widely used magnet design, a cylindrical magnet, is not ideal for guiding procedures as it does not allow direct access to the patient. Open, low field scanners usually operating around 0.2 T, offer this feature. Clumsy hardware, bad patient access, slow image update frequency and strong magnetic fields have been other limiting factors for interventional MRI. However, the advantages of MRI as an imaging modality have been so obvious that considerable development has taken place in the 20-year history of MRI. The image quality has become better, ever faster software, new innovative sequences, better MRI hardware and increased computing power have accelerated imaging speed and image quality to a totally new level. Perhaps the most important feature in the recent development has been the introduction of open configuration low field MRI devices in the early 1990s; this enabled direct patient access and utilization of the MRI as an interventional device. This article reviews the current status of interventional and intraoperative MRI with special emphasis in low field surrounding.
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Affiliation(s)
- Roberto T Blanco
- Department of Radiology, Oulu University Hospital, P.O. Box 90029, Finland.
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22
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Abstract
Magnetic resonance imaging (MRI), which provides superior soft-tissue imaging and no known harmful effects, has the potential as an alternative modality to guide various medical interventions. This review will focus on MR-guided endovascular interventions and present its current state and future outlook. In the first technical part, enabling technologies such as developments in fast imaging, catheter devices, and visualization techniques are examined. This is followed by a clinical survey that includes proof-of-concept procedures in animals and initial experience in human subjects. In preclinical experiments, MRI has already proven to be valuable. For example, MRI has been used to guide and track targeted cell delivery into or around myocardial infarctions, to guide atrial septal puncture, and to guide the connection of portal and systemic venous circulations. Several investigational MR-guided procedures have already been reported in patients, such as MR-guided cardiac catheterization, invasive imaging of peripheral artery atheromata, selective intraarterial MR angiography, and preliminary angioplasty and stent placement. In addition, MR-assisted transjugular intrahepatic portosystemic shunt procedures in patients have been shown in a novel hybrid double-doughnut x-ray/MRI system. Numerous additional investigational human MR-guided endovascular procedures are now underway in several medical centers around the world. There are also significant hurdles: availability of clinical-grade devices, device-related safety issues, challenges to patient monitoring, and acoustic noise during imaging. The potential of endovascular interventional MRI is great because as a single modality, it combines 3-dimensional anatomic imaging, device localization, hemodynamics, tissue composition, and function.
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Affiliation(s)
- Cengizhan Ozturk
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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Schulz T, Tröbs RB, Schneider JP, Hirsch W, Schmidt F, Kahn T. MR Imaging-guided percutaneous procedures in children. Acad Radiol 2005; 12:1128-34. [PMID: 16112513 DOI: 10.1016/j.acra.2005.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Revised: 05/30/2005] [Accepted: 01/30/2005] [Indexed: 10/25/2022]
Abstract
Magnetic resonance imaging (MRI)-guided therapeutic interventions in children are very rare. In comparison to other imaging techniques, it is very unusual for MRI to be used for diagnostic percutaneous interventions despite its imaging benefits. We provide a brief description of available MRI systems and instruments and use clinical examples to present and discuss typical indications for percutaneous procedures while showing possibilities for percutaneous therapeutic interventions.
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Affiliation(s)
- Thomas Schulz
- Department of Diagnostic Diagnostic Radiology, Leipzig University Hospital, Liebigstr 20, 04103, Leipzig, Germany.
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Kee ST, Ganguly A, Daniel BL, Wen Z, Butts K, Shimikawa A, Pelc NJ, Fahrig R, Dake MD. MR-guided transjugular intrahepatic portosystemic shunt creation with use of a hybrid radiography/MR system. J Vasc Interv Radiol 2005; 16:227-34. [PMID: 15713923 DOI: 10.1097/01.rvi.0000143766.08029.6e] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the performance of a combined hybrid radiography/magnetic resonance (MR) unit to guide portal vein (PV) puncture during human transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS Fourteen patients undergoing TIPS creation were studied during standard clinical applications. Patients were anesthetized and then positioned in an open MR unit containing a flat-panel radiographic fluoroscopic unit. With use of a combination of fluoroscopy and MR imaging, the PV was accessed and the TIPS procedure was performed. A noncovered nitinol stent or a covered stent-graft was placed in the TIPS tract. Number of punctures required, total procedure time, fluoroscopy time, procedural success rate, complications, and ultrasonographic and clinical follow-up were recorded. RESULTS Clinical success was obtained in 13 of 14 patients. In one patient, extrahepatic puncture of the PV occurred, resulting in hemorrhage and requiring placement of a covered stent to control the bleeding. The mean number of punctures required to access the PV was 2.6 +/- 1.7, and the total procedure time was 2.5 hours +/- 0.6. Mean fluoroscopy time was 22.3 minutes +/- 5.5. Results of clinical and ultrasonographic follow-up compare favorably to previously published reports. CONCLUSION TIPS creation with a combination hybrid radiography/MR unit is feasible and may reduce the number of needle passes required and radiation exposure, with similar overall outcomes compared with studies reported in the literature.
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Affiliation(s)
- Stephen T Kee
- Department of Radiology, Stanford University, California 94305, USA.
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Warfield SK, Haker SJ, Talos IF, Kemper CA, Weisenfeld N, Mewes AUJ, Goldberg-Zimring D, Zou KH, Westin CF, Wells WM, Tempany CMC, Golby A, Black PM, Jolesz FA, Kikinis R. Capturing intraoperative deformations: research experience at Brigham and Women's Hospital. Med Image Anal 2004; 9:145-62. [PMID: 15721230 DOI: 10.1016/j.media.2004.11.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
During neurosurgical procedures the objective of the neurosurgeon is to achieve the resection of as much diseased tissue as possible while achieving the preservation of healthy brain tissue. The restricted capacity of the conventional operating room to enable the surgeon to visualize critical healthy brain structures and tumor margin has lead, over the past decade, to the development of sophisticated intraoperative imaging techniques to enhance visualization. However, both rigid motion due to patient placement and nonrigid deformations occurring as a consequence of the surgical intervention disrupt the correspondence between preoperative data used to plan surgery and the intraoperative configuration of the patient's brain. Similar challenges are faced in other interventional therapies, such as in cryoablation of the liver, or biopsy of the prostate. We have developed algorithms to model the motion of key anatomical structures and system implementations that enable us to estimate the deformation of the critical anatomy from sequences of volumetric images and to prepare updated fused visualizations of preoperative and intraoperative images at a rate compatible with surgical decision making. This paper reviews the experience at Brigham and Women's Hospital through the process of developing and applying novel algorithms for capturing intraoperative deformations in support of image guided therapy.
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Affiliation(s)
- Simon K Warfield
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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26
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Abstract
The use of intraoperative imaging (IOI) in neurosurgical practice is proving to be yet another important advance in the evolution of brain tumor resection, particularly for the most common adult primary brain tumor--glioblastoma (GBM). The number of surgeons using IOI continues to increase, and the experience to date affords an opportunity to assess the value of the various techniques used for IOI.
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Affiliation(s)
- Vitaly Siomin
- Brain Tumor Institute, Department of Neurosurgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
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