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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Intraoperative imaging using a mobile computed tomographic scanner

Intraoperative Bildgebung unter Verwendung eines mobilen CT

Meeting Abstract

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  • corresponding author Hartmut Gumprecht - Abteilung für Neurochirurgie, Krankenhaus Bogenhausen, Akademisches Lehrkrankenhaus der Technischen Universität München, München
  • C. B. Lumenta - Abteilung für Neurochirurgie, Krankenhaus Bogenhausen, Akademisches Lehrkrankenhaus der Technischen Universität München, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.01.08

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0024.shtml

Published: April 23, 2004

© 2004 Gumprecht 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 radicality of tumor removal in patients suffering from glioma is discussed to be an important factor for longer survival times. Therefore intraoperative imaging modalities like magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) are tested in many neurosurgical facilities for clinical use. In our department a mobile CT for intraoperative applications is used for this purpose since 1999. The handling and useful application of the mobile CT scanner as well as results without intraoperative imaging are discussed.

Methods

470 CT scans with the mobile CT were accomplished, including 270 cases of neuronavigation planning, 76 cases of intraoperative scans, 48 cases of postoperative scans, 69 CT scans for stereotactic biopsy planning and control as well as 3 cases of emergency scanning in trauma patients and 4 spine applications. The results of the intraoperative CT scans are compared with those of the postoperative MRI scans. Additionally 87 patients with glioma were evaluated. These patient underwent surgery without intraoperative imaging.

Results

In 27 out of 43 patients with glioma residual tumor was detected with intraoperative CT. In 13 cases the surgery was resumed to complete resection, in 14 cases the operation was not continued due to close vicinity to eloquent areas or difficulties in image interpretation. In 44 cases the results of intraoperative CT and postoperative MRI were compared. In 6 cases the MRI demonstrated residual tumor in contrast to the results of the CT scans. In 3 cases the tumor removal could have been more complete (6,8%). In 87 cases glioma surgery was performed without intraoperative CT. In 6 cases a more complete tumor removal could have been performed (6,9%) according to the results of postoperative MRI.

Conclusions

Intraoperative imaging with a mobile CT scanner is a good method for detection of residual tumor. The CT scanner can be integrated in an operative setting without problems. Intraoperative imaging with a mobile CT scanner is useful if the borders of a lesion can not be identified clearly under the microscope view, e.g. in diffuse gliomas.