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Multimodality Navigation in Neurosurgery

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Intraoperative Imaging and Image-Guided Therapy

Abstract

Navigation systems are commonly used in neurosurgical operating theaters. In addition to the anatomic magnetic resonance (MR) images, functional information can now also be displayed. This includes structures at risk such as eloquent cortical sites (demonstrated by functional MRI – fMRI) or fiber bundles (demonstrated by fiber tractography). Furthermore positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance spectroscopic imaging (MRSI) enable the visualization of metabolic changes. Their combined display is called multimodality navigation, which has proven to be a beneficial tool to achieve maximum safe resection of intracerebral lesions. To date, this concept of maximum resection with a preservation of neurological function is accepted not only for benign lesions but also for low- and high-grade gliomas. A major addition to the multimodal navigation setup is intraoperative MRI followed by update of the navigation by rigid registration of the pre- with the intraoperative image data. In this way, brain deformations due to loss of cerebrospinal fluid, tumor resection, use of retractors, or edema which is commonly known as brain shift can be compensated for.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Marburg, Marburg, Germany

    Daniela Kuhnt MD, Miriam H. A. Bauer & Christopher Nimsky MD, PhD

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  1. Daniela Kuhnt MD
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  2. Miriam H. A. Bauer
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  3. Christopher Nimsky MD, PhD
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Correspondence to Christopher Nimsky MD, PhD .

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Editors and Affiliations

  1. National Center for Image Guided Therapy, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

    Ferenc A. Jolesz

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Kuhnt, D., Bauer, M.H.A., Nimsky, C. (2014). Multimodality Navigation in Neurosurgery. In: Jolesz, F. (eds) Intraoperative Imaging and Image-Guided Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7657-3_36

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  • DOI: https://doi.org/10.1007/978-1-4614-7657-3_36

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