gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Article

Send article

Integration of navigated transcranial magnetic stimulation data in the clinical workflow

Meeting Abstract

Search Medline for

  • Nico Sollmann - Klinikum rechts der Isar TU München , Klinik für Neurochirurgie, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Sandro Krieg - Klinikum rechts der Isar TU München , Klinik für Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.09.04

doi: 10.3205/17dgnc423, urn:nbn:de:0183-17dgnc4239

Published: June 9, 2017

© 2017 Sollmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Navigated transcranial magnetic stimulation (nTMS) is increasingly used for mapping of various brain functions in neurosurgical departments worldwide. However, when a department starts integrating nTMS data into the clinical workflow, smooth implementation into the existing hospital information system (HIS) and picture archiving and communication system (PACS) are mandatory to promote the use of the newly available data. However, standardized and comprehensive approaches that go beyond the mapping procedure itself have not yet been described.

Methods: To create an effective workflow with regard to nTMS, we present the results of our 6.5 years of experience and progressive integration into clinical software systems and workflow.

Results: After indication for nTMS mapping (motor, language, arithmetic function) is made, registration of the patient within the HIS can be easily achieved by a tailored software mask which can be programmed individually by the manufacturer of the HIS (SAP SE, Walldorf, Germany). This mask includes relevant patient details, contraindications for nTMS, mandatory imaging data, and appointment planning. The same mask can then be used for documentation of the results of the nTMS mapping and nTMS-based tractography, including stimulation details, infiltrated areas, and distances to functionally relevant brain areas. As another important part, nTMS data can be imported into the PACS as DICOM via PACS integrator software (GEMED, Ulm, Germany). In this form, nTMS data can also be used during tumor board discussions. For the surgical planning, nTMS data is then also imported into the neuronavigation software (iPlan Net, BrainLAB, Feldkirchen, Germany). Objects are created from the nTMS data and are then used for nTMS-based tractography of the corticospinal tract or language pathways.

Conclusion: Optimized integration of nTMS data can be achieved by standard software available in most departments. Its easy integration and availability is crucial to promote acceptance and use of nTMS data in clinical routine.