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Structural Imaging and Target Visualization

  • Himanshu Sharma
  • Charles B. MikellEmail author
Chapter
  • 109 Downloads

Abstract

The explosion in neuroimaging techniques beginning in the 1970s has led to a revolution in our ability to identify, define, and visualize targets deep within the brain. These techniques have since been adopted and adapted to the neurosurgical OR, improving outcomes and making new targets amenable to intervention. They simultaneously improve consistency of targeting key structures across patients while allowing for individualization of targets and trajectories for each patient, thus compensating for individual variability as well as disease-specific structural changes. This chapter outlines the theoretical and practical principles of imaging modalities involved in target visualization. These principles are discussed with particular focus on decision making as well as the clinical drawbacks and merits of specific options and approaches. Further, we discuss the integration of these approaches into the neurosurgical workflow, beginning from operative planning and concluding with postsurgical imaging and follow-up. Finally, we engage in a limited discussion of functional neuroimaging in the context of its ability to help define and visualize structural targets in the brain.

Keywords

Neuroimaging MRI Functional neurosurgery DBS Stereotactic Neuroradiology PET fMRI CT 

Abbreviations

ADC

Apparent diffusion coefficient

ALS

Amyotrophic lateral sclerosis

BOLD

Blood oxygen level dependent

CSF

Cerebrospinal fluid

CT

Computed tomography

DBS

Deep brain stimulation

DWI

Diffusion-weighted imaging

EPI

Echo-planar imaging

FDA

Food and Drug Administration

FDG

2[18]F-fluoro-2-deoxy-D-glucose

FLAIR

Fluid-attenuated inversion recovery

fMRI

Functional magnetic resonance imaging

FSE

Fast spin echo

GPi

Globus pallidus internus

GRE

Gradient recalled echo

LITT

Laser interstitial thermal therapy

MRI

Magnetic resonance imaging

OCD

Obsessive-compulsive disorder

PET

Positron emission tomography

RF

Radiofrequency

SE

Spin echo

SN

Substantia nigra

STIR

Short tau inversion recovery

STN

Subthalamic nucleus

SWI

Susceptibility-weighted imaging

T

Tesla

TE

Echo time

TR

Repetition time

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Medical Scientist Training ProgramStony Brook University School of MedicineStony BrookUSA
  2. 2.Department of NeurosurgeryStony Brook University HospitalStony BrookUSA

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