Abstract
Background. Development of an image-guided operation theatre offering multimodal information for mini-invasive neurosurgical brain tumour operations.
Methods. A multi-purpose resistive low-field MR scanner with onoff capability, was installed in a radio frequency-shielded operating room with in-room control panel and display. Intraoperative ultrasound imaging with Doppler mode as needed is used to provide check-up image data between intraoperative MR-imaging sessions. Cortical stimulation and registration are performed during awake craniotomies. The neuronavigation systems are customised armbased and passive optical. The navigation systems show the positions of the ultrasound probe, cortical stimulation electrode, biopsy needles, endoscope and other instruments on the intraoperative MRimages.
Findings. Since 1999, 70 patients (mean age 47, range 3–88 years) have been operated with intraoperative MR-guidance (including 10 tumour biopsies, 56 resections). Twenty-one patients (mean age 46, range 16–67 years) underwent awake craniotomy and tumour resection secured with cortical stimulation and usually preoperative fMRimaging. The present operating environment offered useful multimodal information for surgery of brain tumours in critical locations. Surgical mortality was 0%, morbidity included 3 (4,3%) infections and 2 (2,9%) permanent hemiparesis. Further removal of tumour was continued in 17 cases (57%) out of the 30 cases where intraoperative MR imaging was used for controlling completeness of the resection.
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Tuominen, J., Yrjänä, S.K., Katisko, J.P., Heikkilä, J., Koivukangas, J. (2003). Intraoperative Imaging in a Comprehensive Neuronavigation Environment for Minimally Invasive Brain Tumour Surgery. In: Bernays, R.L., Imhof, HG., Yonekawa, Y. (eds) Intraoperative Imaging in Neurosurgery. Acta Neurochirurgica Supplements, vol 85. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6043-5_16
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DOI: https://doi.org/10.1007/978-3-7091-6043-5_16
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