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Toward an optimal cadaveric brain model for neurosurgical education: assessment of preservation, parenchyma, vascular injection, and imaging

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Abstract

Objective

We assessed types of cadaveric head and brain tissue specimen preparations that are used in a high throughput neurosurgical research laboratory to determine optimal preparation methods for neurosurgical anatomical research, education, and training.

Methods

Cadaveric specimens (N = 112) prepared using different preservation and vascular injection methods were imaged, dissected, and graded by 11 neurosurgeons using a 21-point scale. We assessed the quality of tissue and preservation in both the anterior and posterior circulations. Tissue quality was evaluated using a 9-point magnetic resonance imaging (MRI) scale.

Results

Formalin-fixed specimens yielded the highest scores for assessment (mean ± SD [17.0 ± 2.8]) vs. formalin-flushed (17.0 ± 3.6) and MRI (6.9 ± 2.0). Cadaver assessment and MRI scores were positively correlated (P < 0.001, R2 0.60). Analysis showed significant associations between cadaver assessment scores and specific variables: nonformalin fixation (β = −3.3), preservation within ≤72 h of death (β = 1.8), and MRI quality score (β = 0.7). Formalin-fixed specimens exhibited greater hardness than formalin-flushed and nonformalin-fixed specimens (P ≤ 0.006). Neurosurgeons preferred formalin-flushed specimens injected with colored latex.

Conclusion

For better-quality specimens for neurosurgical education and training, formalin preservation within ≤72 h of death was preferable, as was injection with colored latex. Formalin-flushed specimens more closely resembled live brain parenchyma. Assessment scores were lower for preparation techniques performed > 72 h postmortem and for nonformalin preservation solutions. The positive correlation between cadaver assessment scores and our novel MRI score indicates that donation organizations and institutional buyers should incorporate MRI as a screening tool for the selection of high-quality specimens.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request and IRB approval, as applicable.

Abbreviations

ANOVA:

analysis of variance

CT:

computed tomography

HRD:

high radiodensity

IFG:

inferior frontal gyrus

kPa:

kilopascal

MRI:

magnetic resonance imaging

R2 :

coefficient of determination

3D:

3-dimensional

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Acknowledgements

We thank the staff of Neuroscience Publications at Barrow Neurological Institute for assistance with manuscript preparation. This study was presented in part at the 2022 Congress of Neurological Surgeons Annual Meeting in San Francisco, CA (October 8-12, 2022).

Funding

This study was funded by the Newsome Chair in Neurosurgery Research held by Dr. Preul and the Barrow Neurological Foundation.

Author information

Authors and Affiliations

  1. The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ, 85013, USA

    Giancarlo Mignucci-Jiménez, Yuan Xu, Thomas J. On, Irakliy Abramov, Lena Mary Houlihan, Redi Rahmani, Grant Koskay, Sahin Hanalioglu, Ali Tayebi Meybodi, Michael T. Lawton & Mark C. Preul

  2. Robert F. Spetzler Chair in Neuroscience, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ, 85013, USA

    Michael T. Lawton

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  1. Giancarlo Mignucci-Jiménez
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  2. Yuan Xu
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  3. Thomas J. On
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Contributions

Conceptualization: MCP, LMH, GMJ, MTL. Data curation: GMJ, YX, IA, LMH, RR, SH. Formal analysis: GMJ, YX, LMH, GK. Funding acquisition: Investigation: Methodology: MCP, LMH, GMJ. Project administration: Resources: Software: Supervision: MCP. Validation: Visualization: Roles/Writing - original draft: GMJ, YX, GK, ATM, MCP. Writing - review & editing: MCP, MTL, TJO.

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Correspondence to Mark C. Preul.

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Mignucci-Jiménez, G., Xu, Y., On, T.J. et al. Toward an optimal cadaveric brain model for neurosurgical education: assessment of preservation, parenchyma, vascular injection, and imaging. Neurosurg Rev 47, 190 (2024). https://doi.org/10.1007/s10143-024-02363-7

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