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Intraoperative Imaging, An Issue of Neurosurgery Clinics of North America, E-Book

Intraoperative Imaging, An Issue of Neurosurgery Clinics of North America, E-Book

J. Bradley Elder | Ganesh Rao

(2017)

Additional Information

Book Details

Abstract

This issue of Neurosurgery Clinics focus on Intraoperative Imaging. Article topics will include historical, current and future intraoperative imaging modality; iMRI suites: history, design, utility and cost-effectiveness; Stereotactic platforms for iMRI; iMRI for tumor: maximizing extent of resection of glioma; IMRI for tumor: combining iMRI with functional MRI; iMRI for tumor: pituitary adenoma; iMRI for tumor: MR thermometry; iMRI for tumor: LITT for spinal tumors; iMRI for functional/epilepsy neurosurgery: DBS placement; iMRI for functional/epilepsy neurosurgery: MR thermometry for mesial temporal epilepsy; iMRI for functional/epilepsy neurosurgery: MR thermometry HIFU; Fluorescence imaging/agents in tumor resection; Intraoperative 3D ultrasound; Intraoperative 3D CT: spine surgery; Intraoperative 3D CT: cranial/functional/trigem; Intraoperative imaging for vascular lesions; Imaging of intraoperative drug delivery; Intraoperative ultrasound for peripheral nerve; and Intraoperative Raman Spectroscopy.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Intraoperative Imaging\r i
Copyright\r ii
Contributors iii
CONSULTING EDITORS iii
EDITORS iii
AUTHORS iii
Contents vii
Preface vii
Historical, Current, and Future Intraoperative Imaging Modalities vii
Stereotactic Biopsy Platforms with Intraoperative Imaging Guidance vii
Intraoperative MRI and Maximizing Extent of Resection vii
Combining Functional Studies with Intraoperative MRI in Glioma Surgery vii
iMRI During Transsphenoidal Surgery viii
A Novel Use of the Intraoperative MRI for Metastatic Spine Tumors: Laser Interstitial Thermal Therapy for Percutaneous Trea ... viii
Magnetic Resonance Thermometry and Laser Interstitial Thermal Therapy for Brain Tumors viii
Interventional MRI–Guided Deep Brain Stimulation Lead Implantation viii
MRI-Guided Laser Interstitial Thermal Therapy for Epilepsy ix
Neurosurgical Applications of High-Intensity Focused Ultrasound with Magnetic Resonance Thermometry ix
Fluorescence Imaging/Agents in Tumor Resection ix
Intraoperative 3D Computed Tomography: Spine Surgery ix
Intraoperative Computed Tomography in Cranial Neurosurgery x
Intraoperative Imaging for Vascular Lesions x
Imaging of Convective Drug Delivery in the Nervous System x
Intraoperative Ultrasound for Peripheral Nerve Applications x
Intraoperative Raman Spectroscopy xi
NEUROSURGERY CLINICS OF NORTH AMERICA\r xii
FORTHCOMING ISSUE xii
January 2018 xii
RECENT ISSUES xii
July 2017 xii
April 2017 xii
Preface xiii
Historical, Current, and Future Intraoperative Imaging Modalities 453
Key point 453
INTRODUCTION: INTRAOPERATIVE IMAGING MODALITIES 453
NAVIGATION AND IMAGING 454
INTRAOPERATIVE X-RAY FLUOROSCOPY AND INTRAOPERATIVE ANGIOGRAPHY 454
INTRAOPERATIVE FLUORESCENCE TECHNIQUES AND OTHERS 455
INTRAOPERATIVE ULTRASONOGRAPHY 455
INTRAOPERATIVE COMPUTED TOMOGRAPHY 456
INTRAOPERATIVE MRI 457
FUTURE 458
REFERENCES 459
Stereotactic Biopsy Platforms with Intraoperative Imaging Guidance 465
Key points 465
INTRODUCTION 465
FRAMELESS STEREOTACTIC BIOPSY PLATFORMS WITH PREOPERATIVE IMAGE GUIDANCE 466
FRAMELESS STEREOTACTIC BIOPSY PLATFORMS WITH INTRAOPERATIVE IMAGE GUIDANCE 467
The ClearPoint System Neuronavigation Platform 468
Imaging System and Operating Room 468
Surgical Technique 468
CASE ILLUSTRATION 470
INTEGRATION OF FRAMELESS STEREOTACTIC BIOPSY PLATFORMS WITH INTRAOPERATIVE IMAGE GUIDANCE AND LASER ABLATION THERAPY 470
SUMMARY 472
REFERENCES 473
Intraoperative MRI and Maximizing Extent of Resection 477
Key points 477
INTRODUCTION 477
Surgery for Glial Neoplasms 477
Radiographic Qualities of Glial Tumors 477
EXTENT OF RESECTION AND OUTCOME 478
HISTORY OF INTRAOPERATIVE MRI 479
USE OF INTRAOPERATIVE MRI TO MAXIMIZE EXTENT OF RESECTION 480
Incorporating Other Surgical Adjuncts into the Intraoperative MRI Environment to Maximize Resection 482
OTHER CONSIDERATIONS 482
Cost and Accessibility of Intraoperative MRI 482
Complication Avoidance in the Intraoperative MRI Operating Room 483
SUMMARY 483
REFERENCES 483
Combining Functional Studies with Intraoperative MRI in Glioma Surgery 487
Key points 487
INTRODUCTION 487
FUNCTIONAL STUDIES THAT CAN BE PERFORMED PREOPERATIVELY OR INTRAOPERATIVELY 488
Functional MRI 488
Intraoperative functional MRI 488
Resting-state functional MRI 489
Intraoperative resting-state functional MRI 489
Diffusion Tensor Imaging 489
Intraoperative diffusion tensor imaging 490
Magnetic Resonance Spectroscopy 491
Intraoperative MRS 491
Perfusion Imaging 492
5-Aminolevulinic Acid 492
ADDITIONAL PREOPERATIVE FUNCTIONAL ADJUNCTS 492
Magnetoencephalography 493
Navigated Transcranial Magnetic Stimulation 493
PET 493
Deformable Anatomic Templates 493
Multimodality Navigation 494
REFERENCES 494
iMRI During Transsphenoidal Surgery 499
Key points 499
INTRODUCTION 499
INTRAOPERATIVE MRI FOR TRANSSPHENOIDAL SURGERY 500
History of Intraoperative Imaging During Transsphenoidal Surgery 500
History of Intraoperative MRI for Transsphenoidal Surgery 500
Types of Intraoperative MRI Systems 500
Field strength 505
Magnet configuration 505
Room configuration 505
Indications for Intraoperative MRI During Transsphenoidal Surgery 505
Stereotaxy and neuronavigation 505
Resection control 505
Complication detection and avoidance 507
Microadenoma detection 507
Safety/Pitfalls of Using Intraoperative MRI During Transsphenoidal Surgery 507
Future Directions 508
SUMMARY 509
REFERENCES 510
A Novel Use of the Intraoperative MRI for Metastatic Spine Tumors 513
Key points 513
RATIONALE FOR LASER INTERSTITIAL THERMAL THERAPY 514
PATIENT SELECTION 515
TECHNIQUE 515
PLACEMENT OF EPIDURAL CATHETERS 517
THERMAL ABLATION 518
ESTIMATION OF THERMAL DAMAGE 518
PERCUTANEOUS STABILIZATION AND FOLLOW-UP 518
QUANTITATIVE ASSESSMENT OF PATIENT OUTCOMES 519
RESULTS 520
LASER ABLATION AND PERCUTANEOUS STABILIZATION 521
LIMITATIONS AND FUTURE DIRECTIONS 522
SUMMARY 522
REFERENCES 522
Magnetic Resonance Thermometry and Laser Interstitial Thermal Therapy for Brain Tumors 525
Key points 525
INTRODUCTION 525
PRINCIPLES AND RATIONALE OF LASER INTERSTITIAL THERMAL THERAPY 525
TECHNICAL NUANCES AND COMMERCIALLY AVAILABLE SYSTEMS 526
Lasers and Probes Used for Laser Interstitial Thermal Therapy 526
Laser Interstitial Thermal Therapy Probes 527
MAGNETIC RESONANCE THERMOGRAPHY AND IMAGE ACQUISITION 527
COMMERCIALLY AVAILABLE LASER INTERSTITIAL THERMAL THERAPY SYSTEMS USED IN NEUROSURGERY 527
CLINICAL APPLICATIONS FOR LASER INTERSTITIAL THERMAL THERAPY 528
Neoplastic Disease 528
High-Grade Gliomas 528
Brain Metastatic Disease 529
Radiation Necrosis 529
SUMMARY 531
REFERENCES 531
Interventional MRI–Guided Deep Brain Stimulation Lead Implantation 535
Key points 535
INTRODUCTION 535
PROSPECTIVE STEREOTAXY AND THE DEVELOPMENT OF INTERVENTIONAL MRI FOR DEEP BRAIN STIMULATION 536
PATIENT SELECTION CRITERIA FOR INTERVENTIONAL MRI–DEEP BRAIN STIMULATION PROCEDURES 536
THE INTERVENTIONAL MRI–DEEP BRAIN STIMULATION ENVIRONMENT 537
THE INTERVENTIONAL MRI-DEEP BRAIN STIMULATION TECHNIQUE 537
MRI SEQUENCES FOR ANATOMIC TARGETING 540
ACCURACY OF INTERVENTIONAL MRI–DEEP BRAIN STIMULATION ELECTRODE PLACEMENT 541
CLINICAL OUTCOMES IN INTERVENTIONAL MRI–DEEP BRAIN STIMULATION 543
COMPLICATIONS OF INTERVENTIONAL MRI–DEEP BRAIN STIMULATION 543
SUMMARY 543
REFERENCES 543
MRI-Guided Laser Interstitial Thermal Therapy for Epilepsy 545
Key points 545
INTRODUCTION 545
TECHNICAL CONSIDERATIONS AND GENERAL TECHNIQUE 545
Preincision and Anesthesia 545
Delivering the Laser 546
Frame-Based Stereotaxy 546
Frameless Stereotaxy 546
Trajectory Planning 547
Planning for Heat Sinks 547
Implanting the Laser 547
Intraoperative Imaging and Thermometry 547
Medtronic Visualase 548
Use of Low-Limit Markers 548
Monteris Neuroblate 548
MR Thermogram Limitations 548
Confirmatory Imaging 548
Postoperative Care 549
TECHNICAL TIPS AND TROUBLESHOOTING 549
Special Considerations in Cranial Immobilization 549
Troubleshooting Transcranial Bolts 549
Craniectomized or thin bone 549
Dislodged skull bolt 550
FOCAL EPILEPSIES 550
Temporal 550
ILLUSTRATIVE CASE 1 552
Extratemporal 552
Focal cortical dysplasia 552
Hypothalamic hamartoma 553
Tuberous sclerosis complex 553
Periventricular nodular heterotopia 554
Epitomas 554
ILLUSTRATIVE CASE 2 554
GENERALIZED EPILEPSIES 554
SUMMARY 555
REFERENCES 555
Neurosurgical Applications of High-Intensity Focused Ultrasound with Magnetic Resonance Thermometry 559
Key points 559
INTRODUCTION 559
THERMAL ABLATIONS 560
Thermal Ablation in Brain Tumors 561
Thermal Ablation in Nonneoplastic Central Nervous System Diseases 561
NONTHERMAL EFFECTS 563
SUMMARY 565
REFERENCES 566
Fluorescence Imaging/Agents in Tumor Resection 569
Key points 569
INTRODUCTION 569
FLUORESCENCE: THEORETIC BACKGROUND 570
SELECTIVITY OF ACCUMULATION 570
TIME-DEPENDENCY OF SIGNAL SELECTIVITY AND SIGNAL STRENGTH 571
VISIBILITY OF THE FLUOROCHROME TO THE SURGEON 571
5-AMINOLEVULINIC ACID 572
BIOCHEMICAL BACKGROUND AND SAFETY 572
5-AMINOLEVULINIC ACID IN MALIGNANT GLIOMAS 573
RELATIONSHIP BETWEEN 5-AMINOLEVULINIC ACID AND GADOLINIUM UPTAKE ON MRI 573
5-AMINOLEVULINIC ACID FOR OTHER GLIOMAS APART FROM GLIOBLASTOMAS 575
OTHER TUMOR ENTITIES AMENABLE TO USE OF 5-AMINOLEVULINIC ACID 575
PRACTICAL USE 576
FLUORESCEIN 577
TARGETED FLUOROPHORES 579
SUMMARY 579
SUPPLEMENTARY DATA 579
REFERENCES 579
Intraoperative 3D Computed Tomography 585
Key points 585
HISTORY OF IMAGE-GUIDED INSTRUMENTATION OF THE SPINE 585
THREE-DIMENSIONAL NAVIGATION IN ADULT SPINE SURGERY: TECHNIQUES 586
THREE-DIMENSIONAL NAVIGATION IN ADULT SPINE SURGERY: OUTCOMES 586
THREE-DIMENSIONAL NAVIGATION IN PEDIATRIC SPINE SURGERY 588
THREE-DIMENSIONAL NAVIGATION IN MINIMALLY INVASIVE SPINE SURGERY 589
RADIATION EXPOSURE IN TWO-DIMENSIONAL COMPARED WITH THREE-DIMENSIONAL NAVIGATION 590
THE LATEST TECHNOLOGY: THREE-DIMENSIONAL PRINTING MODELS 590
THREE-DIMENSIONAL NAVIGATION FOR THE NEUROSURGICAL RESIDENT 592
SUMMARY 592
REFERENCES 593
Intraoperative Computed Tomography in Cranial Neurosurgery 595
Key points 595
INTRODUCTION 595
METHODS AND TECHNOLOGY 596
RESULTS 596
Work Flow 596
Radiation Exposure 597
Skullbase Neurosurgery 597
Neuronavigation 597
Control of resection 598
Vascular Neurosurgery 598
Intraoperative CT-angiography (iCTA) 598
Intraoperative perfusion CT (iCT-perfusion) 598
Adverse Events 599
DISCUSSION 600
SUMMARY 601
REFERENCES 601
Intraoperative Imaging for Vascular Lesions 603
Key points 603
INTRODUCTION 603
DIGITAL SUBTRACTION ANGIOGRAPHY 603
Aneurysm Surgery 604
Extracranial–Intracranial and Intracranial–Intracranial Bypass 604
Arteriovenous Malformation Resection 605
Dural Arteriovenous Fistula Obliteration 605
Additional Limitations of Digital Subtraction Angiography 605
INDOCYANINE GREEN DYE VIDEO ANGIOGRAPHY 605
Aneurysm Surgery 606
Extracranial–Intracranial and Intracranial–Intracranial Bypass 606
Arteriovenous Malformation Resection 606
Dural Arteriovenous Fistula Obliteration 607
Dual-Image Videoangiography 607
FLOW 800 607
FLUORESCEIN ANGIOGRAPHY 608
MICROVASCULAR DOPPLER ULTRASONOGRAPHY 608
Microvascular Ultrasonic Flow Probe 608
LASER DOPPLER FLOWMETRY AND LASER DOPPLER IMAGING 608
LASER SPECKLE CONTRAST IMAGING AND MULTIEXPOSURE SPECKLE IMAGING 609
NEURONAVIGATION 609
Intraoperative Computed Tomography Angiography 609
Intraoperative MRI 609
NEUROENDOSCOPY 609
SUMMARY 609
REFERENCES 609
Imaging of Convective Drug Delivery in the Nervous System 615
Key points 615
INTRODUCTION 615
CONVECTION-ENHANCED DELIVERY 615
IMAGING CONVECTIVE DELIVERY 616
Surrogate Tracers 616
Real-time imaging convective drug delivery 616
Rationale for surrogate imaging tracers 616
CT scanning surrogate imaging tracers 616
MRI surrogate tracers 617
Other MRI surrogate tracers 617
Other MRI methods 617
Clinical application of surrogate imaging tracers 618
Potential limitations of surrogate tracers 618
SUMMARY 620
REFERENCES 620
Intraoperative Ultrasound for Peripheral Nerve Applications 623
Key points 623
INTRODUCTION 623
EXTRAOPERATIVE UTILIZATION OF ULTRASOUND FOR PERIPHERAL NERVE DISORDERS 624
Nerve Entrapments 624
Mass Lesions 625
Peripheral Nerve Trauma 626
INTRAOPERATIVE LOCALIZATION OF PERIPHERAL NERVES 626
INTRAOPERATIVE LOCALIZATION OF PERIPHERAL NERVES USING ULTRASOUND 627
OTHER USES OF INTRAOPERATIVE ULTRASOUND IN PERIPHERAL NERVE SURGERY 627
NEW USES OF PERIOPERATIVE/INTRAOPERATIVE ULTRASOUND FOR PERIPHERAL NERVE DISORDERS 628
SUMMARY 629
REFERENCES 630
Intraoperative Raman Spectroscopy 633
Key points 633
INTRODUCTION 633
RAMAN SPECTROSCOPY 634
EARLY APPLICATIONS OF NEUROLOGIC RAMAN SPECTROSCOPY 636
EARLY APPLICATIONS OF IN VIVO RAMAN SPECTROSCOPY 643
DEVELOPMENTS TOWARD IN VIVO NEUROSURGICAL DIAGNOSTICS 644
SURFACE-ENHANCED RAMAN SPECTROSCOPY 647
SPATIALLY OFFSET RAMAN SPECTROSCOPY 647
TRANSMISSION RAMAN SPECTROSCOPY 648
COHERENT ANTI-STOKES RAMAN SPECTROSCOPY 648
STIMULATED RAMAN SPECTROSCOPY 648
RESONANCE RAMAN SCATTERING 649
SUMMARY AND FUTURE DIRECTIONS 649
ACKNOWLEDGMENTS 649
REFERENCES 649