gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

3D processing softwares of MRI imaging and their application for targeting and removal of deep brain tumours: a new system

Meeting Abstract

  • corresponding author S. Sherkat - Department of Neurosurgery, San Filippo Neri Hospital of Rome, Italy
  • G. Gazzeri - Department of Neurosurgery, San Filippo Neri Hospital of Rome, Italy
  • A. Faiola - Department of Neurosurgery, San Filippo Neri Hospital of Rome, Italy
  • D. Fiume - Department of Neurosurgery, San Filippo Neri Hospital of Rome, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 083

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Sherkat et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: 3d processing software programs (3d PS) allow tridimensional rendering of CT/MRI images. Their widespread and costless availability made them a useful tool for preoperative planning of brain surgical procedures. 3d PS are freeware and may be easily downloaded from the web on any personal computer or laptop. Every cerebral structure (giri, sulci, vessels, etc) of the individual is displayed in order to plan the most appropriate craniotomy.

The Region and Point of interest utility (ROI and POI) allow the user to outline targeted cerebral structures and represents a further helpful feature of these programs. By this function, one can preoperatively study the anatomic relationship between eloquent cortical areas and the planned surgical field.

The observation that a POI, drawn inside the MRI of the lesion, projects on the 3d reconstructed picture orthogonally, prompted us to exploit this feature by creating a new system for the surgery of subcortical brain tumours.

Methods: This system is based upon a device that supports a catheter driver. It allows frameless procedures, both by perpendicular and oblique trajectories through a guided catheter introduced from the planned cortical entry point toward the lesion.

We describe this new system reporting two explicative cases in which perpendicular and oblique trajectories were used for the targeting and the removal of a left temporal glioblastoma and a left ventricle meningioma.

Conclusions: This 3d PS guided system proved to be a versatile, handy and costless solution for frameless surgery of deep brain masses. Furthermore, this new procedure is not biased by the brain shift occurring during surgery.