gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Neuronavigation based on intraoperative 3D-ultrasound during tumour resection

Auf intraoperativen 3D-Ultraschall basierende Neuronavigation während der Tumorresektion

Meeting Abstract

  • corresponding author D. Lindner - Klinik für Neurochirurgie, Universität Leipzig
  • C. Trantakis - Klinik für Neurochirurgie, Universität Leipzig
  • S. Arnold - Fraunhofer Institut für Angewandte Informationstechnik FIT, St. Augustin
  • A. Schmitgen - Klinik für Diagnostische Radiologie, Universität Leipzig
  • J. Schneider - Klinik für Diagnostische Radiologie, Universität Leipzig
  • J. Meixensberger - Klinik für Neurochirurgie, Universität Leipzig

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-11.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0230.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Lindner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Intraoperative imaging such as ultrasound is beneficial for intraoperative orientation, detection of brain shift and resection control. A combination of preoperative MRI with intraoperative 3D-ultrasound (3D-iUS) may enhance the convenience of neuronavigation by adding intraoperative information. The aim of our study was to evaluate fusion accuracy, the benefit of 3D US navigation for the extent of resection and the suitability of iUS for detection and capture of intraoperative brain shift.

Methods

A freehand 3D ultrasound navigation system consisting of a standard personal computer containing a video grabber card in combination with an optical tracking system (NDI Polaris) and a standard ultrasound device (Siemens Omnia) with a 5,0 MHz probe was used. 3D-iUS datasets were acquired after craniotomy, at different subsequent times of the procedure and overlayed with preoperative MRI. The study included 23 patients. The tumours contained a size from 1-7 cm and 95% were located supratentorally. In a standard protocol six surgeons removed eight metastasis, six glioblastomas, three anaplastic glioma, three meningeoma, one angioma, lymphoma and one cystic process. All patients underwent early postoperative MRI within 24 hours after surgery.

Results

In all cases except one the acquisition of 3D-iUS and the fusion with preoperative MRI was successful. The expenditure of time was at least 5 minutes for one 3D-iUS dataset. All users accepted handling of the system but there was a learning curve. The quality of ultrasound images was superior in cases of metastasis, meningeoma and angioma to those in malignant glioma. Brain shifting ranged from 2 – 25 mm depending on localisation and kind of tumour. A resection control was possible in 78%. A good correlation between postoperative MRI and the last 3D-iUS dataset showed only 14/22 cases.

Conclusions

Accurate fusion of MR images and intraoperative acquired 3D-iUS was successful in all cases except one. Configuration of the 3D-iUS based on a standard ultrasound system and the MR-navigation system is time- and especially cost-effective. Tumour resection control was excellent in cases of metastasis, meningeoma and cystic glioma.