gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Brain surface reformatted imaging for intraoperative navigation in brain tumor surgery

Meeting Abstract

  • Marie-Therese Forster - Klinik für Neurochirurgie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
  • Elke Hattingen - Klinik für Neuroradiologie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
  • Florian Gessler - Klinik für Neurochirurgie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
  • Johanna Quick - Klinik für Neurochirurgie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
  • Volker Seifert - Klinik für Neurochirurgie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
  • Christian Senft - Klinik für Neurochirurgie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.19.09

doi: 10.3205/14dgnc395, urn:nbn:de:0183-14dgnc3953

Published: May 13, 2014

© 2014 Forster et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: The aim of this study was to evaluate brain surface reformatted imaging (BSRI) in a neuronavigation system for localizing brain tumors.

Method: Eight patients suffering from perirolandic tumors were preoperatively studied with high resolution magnetic resonance imaging (MRI) and navigated transcranial magnetic stimulation (nTMS). In a second step, high resolution MRI were loaded in a neuronavigation software (Brainlab®) which automatically transformed these data into BSR images. One experienced neuroradiologist, one experienced neurosurgeon and two residents determined hand representation areas ipsilateral to each tumor on conventional two-dimensional (2D) MR images and on BSR images. All results were compared to nTMS results. In addition, time needed for hand representation area determination on standard MR images and BSR images was recorded in every case, and observers judged wheter localization was difficult or easy.

Results: When compared to nTMS results, hand representation areas were correctly determined by BSRI in all but six cases (84.4%). However, on 2D-MR images only two respective incorrect localizations occured. In a subgroup analysis, experienced observers showed significantly more familiarity with BSRI than residents (93.8% vs 68.8% correct answers, p=0.001), with an equal error rate for 2D-MR images. Time required to define hand representation areas was significantly shorter using BSRI than using conventional 2D-MRI (mean 40.4 vs. 27.4 seconds, p=0.04). Judgement of difficulty in determining the precentral gyrus did not differ between 2D-MRI and BSRI.

Conclusions: BSRI enables fast and easy intraoperative localization of distinct brain regions, such as the precentral gyrus in tumor-associated distortions of brain anatomy. Thus, with BSRI a new and reliable intraoperative method for neuronavigation is now available.