Postimaging brain distortion: magnitude, correlates, and impact on neuronavigation

Neil L. Dorward Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by Neil L. Dorward in
Current site
Google Scholar
PubMed
Close
 F.R.C.S.
,
Olaf Alberti Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by Olaf Alberti in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Binti Velani Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by Binti Velani in
Current site
Google Scholar
PubMed
Close
 B.Sc.
,
Frans A. Gerritsen Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by Frans A. Gerritsen in
Current site
Google Scholar
PubMed
Close
 Ph.D.
,
William F. J. Harkness Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by William F. J. Harkness in
Current site
Google Scholar
PubMed
Close
 F.R.C.S.
,
Neil D. Kitchen Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by Neil D. Kitchen in
Current site
Google Scholar
PubMed
Close
 F.R.C.S.
, and
David G. T. Thomas Gough-Cooper Department of Neurological Surgery, Institute of Neurology, London, United Kingdom; Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; and Integrated Clinical Solutions, Philips Medical Systems B.V., Best, The Netherlands

Search for other papers by David G. T. Thomas in
Current site
Google Scholar
PubMed
Close
 F.R.C.P., F.R.C.S.
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $536.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $636.00
USD  $45.00
USD  $536.00
USD  $636.00
Print or Print + Online Sign in

Object. This prospective study was conducted to quantify brain shifts during open cranial surgery, to determine correlations between these shifts and image characteristics, and to assess the impact of postimaging brain distortion on neuronavigation.

Methods. During 48 operations, movements of the cortex on opening, the deep tumor margin, and the cortex at completion were measured relative to the preoperative image position with the aid of an image-guidance system. Bone surface offset was used to assess system accuracy and correct for registration errors. Preoperative images were examined for the presence of edema and to determine tumor volume, midline shift, and depth of the lesion below the skin surface. Results were analyzed for all cases together and separately for four tumor groups: 13 meningiomas, 18 gliomas, 11 nonglial intraaxial lesions, and six skull base lesions.

For all 48 cases the mean shift of the cortex after dural opening was 4.6 mm, shift of the deep tumor margin was 5.1 mm, and shift of the cortex at completion was 6.7 mm. Each tumor group displayed unique patterns of shift, with significantly greater shift at depth in meningiomas than gliomas (p = 0.007) and significantly less shift in skull base cases than other groups (p = 0.003). Whereas the preoperative image characteristics correlating with shift of the cortex on opening were the presence of edema and depth of the tumor below skin surface, predictors of shift at depth were the presence of edema, the lesion volume, midline shift, and magnitude of shift of the cortex on opening.

Conclusions. This study quantified intraoperative brain distortion, determined the different behavior of tumors in four pathological groups, and identified preoperative predictors of shift with which the reliability of neuronavigation may be estimated.

  • Collapse
  • Expand
  • 1.

    Barnett GH, , Kormos DW, & Steiner CP, et al: Use of a frameless, armless stereotactic wand for brain tumor localization with two-dimensional and three-dimensional neuroimaging. Neurosurgery 33:674678, 1993 Barnett GH, Kormos DW, Steiner CP, et al: Use of a frameless, armless stereotactic wand for brain tumor localization with two-dimensional and three-dimensional neuroimaging. Neurosurgery 33:674–678, 1993

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Barnett GH, , Steiner CP, & Weisenberger J: Intracranial meningioma resection using frameless stereotaxy. J Image Guided Surg 1:4652, 1995 Barnett GH, Steiner CP, Weisenberger J: Intracranial meningioma resection using frameless stereotaxy. J Image Guided Surg 1:46–52, 1995

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Bucholz R, , Sturm C, & Henderson J: Detection of brain shift with an image guided ultrasound device. Acta Neurochir 138:627, 1996 (Abstract) Bucholz R, Sturm C, Henderson J: Detection of brain shift with an image guided ultrasound device. Acta Neurochir 138:627, 1996 (Abstract)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Bucholz RD, & Smith KR: A comparison of sonic digitizers versus light emitting diode-based localization, in Maciunas RJ (ed): Interactive Image-Guided Neurosurgery. Park Ridge, Ill: American Association of Neurological Surgeons, 1993, pp 179200 Bucholz RD, Smith KR: A comparison of sonic digitizers versus light emitting diode-based localization, in Maciunas RJ (ed): Interactive Image-Guided Neurosurgery. Park Ridge, Ill: American Association of Neurological Surgeons, 1993, pp 179–200

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Buurman J, & Gerritsen FA: European Applications in Surgical Interventions (EASI), in Lemke HU, , Vannier MW, & Inamura K, et al (eds): CAR ‘96. Computer Assisted Radiology. Amsterdam: Elsevier, 1996 pp 677685 Buurman J, Gerritsen FA: European Applications in Surgical Interventions (EASI), in Lemke HU, Vannier MW, Inamura K, et al (eds): CAR ‘96. Computer Assisted Radiology. Amsterdam: Elsevier, 1996 pp 677–685

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Dorward NL: Neuronavigation—the surgeon's sextant. Br J Neurosurg 11:101103, 1997 Dorward NL: Neuronavigation—the surgeon's sextant. Br J Neurosurg 11:101–103, 1997

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Drake JM, , Rutka JT, & Hoffman HJ: ISG viewing wand system. Neurosurgery 34:10941097, 1994 Drake JM, Rutka JT, Hoffman HJ: ISG viewing wand system. Neurosurgery 34:1094–1097, 1994

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Fuchs M, , Wischmann HA, & Neumann A, et al: Accuracy analysis for image-guided neurosurgery using fiducial skin markers, 3D CT imaging and an optical localizer system, in Lemke HU, , Vannier MW, & Inamura K, et al (eds): CAR ‘96. Computer Assisted Radiology. Amsterdam: Elsevier, 1996, pp 770775 Fuchs M, Wischmann HA, Neumann A, et al: Accuracy analysis for image-guided neurosurgery using fiducial skin markers, 3D CT imaging and an optical localizer system, in Lemke HU, Vannier MW, Inamura K, et al (eds): CAR ‘96. Computer Assisted Radiology. Amsterdam: Elsevier, 1996, pp 770–775

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Golfinos JG, , Fitzpatrick BC, & Smith LR, et al: Clinical use of a frameless stereotactic arm: results of 325 cases. J Neurosurg 83:197205, 1995 Golfinos JG, Fitzpatrick BC, Smith LR, et al: Clinical use of a frameless stereotactic arm: results of 325 cases. J Neurosurg 83:197–205, 1995

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Henderson JM, , Eichholz KM, & Bucholz RD: Decreased length of stay and hospital costs in patients undergoing image-guided craniotomies. J Neurosurg 86:367A, 1997 (Abstract) Henderson JM, Eichholz KM, Bucholz RD: Decreased length of stay and hospital costs in patients undergoing image-guided craniotomies. J Neurosurg 86:367A, 1997 (Abstract)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Kelly PJ: Stereotactic excision of brain tumours, in Thomas DGT (ed): Stereotactic and Image Directed Surgery of Brain Tumours. Edinburgh: Churchill Livingstone, 1993, pp 89109 Kelly PJ: Stereotactic excision of brain tumours, in Thomas DGT (ed): Stereotactic and Image Directed Surgery of Brain Tumours. Edinburgh: Churchill Livingstone, 1993, pp 89–109

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Kelly PJ, , Kall BA, & Goerss SJ: Results of computed tomography-based computer-assisted stereotactic resection of metastatic intracranial tumors. Neurosurgery 22:717, 1988 Kelly PJ, Kall BA, Goerss SJ: Results of computed tomography-based computer-assisted stereotactic resection of metastatic intracranial tumors. Neurosurgery 22:7–17, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Koivukangas J, , Louhisalmi Y, & Alakuijala J, et al: Ultrasound-controlled neuronavigator-guided brain surgery. J Neurosurg 79:3642, 1993 Koivukangas J, Louhisalmi Y, Alakuijala J, et al: Ultrasound-controlled neuronavigator-guided brain surgery. J Neurosurg 79:36–42, 1993

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Kwoh YS, , Hou J, & Jonckheere EA, et al: A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Biomed Eng 35:153160, 1988 Kwoh YS, Hou J, Jonckheere EA, et al: et al:A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Biomed Eng 35:153–160, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Lunsford LD, , Kondziolka D, & Bissonette DJ: Intraoperative imaging of the brain. Stereotact Funct Neurosurg 66:5864, 1996 Lunsford LD, Kondziolka D, Bissonette DJ: Intraoperative imaging of the brain. Stereotact Funct Neurosurg 66:58–64, 1996

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Maciunas RJ (ed): Interactive Image-Guided Neurosurgery. Park Ridge, Ill: American Association of Neurological Surgeons, 1993 Maciunas RJ (ed): Interactive Image-Guided Neurosurgery. Park Ridge, Ill: American Association of Neurological Surgeons, 1993

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Maciunas RJ, , Galloway RL Jr, & Latimer J, et al: An independent application accuracy evaluation of stereotactic frame systems. Stereotact Funct Neurosurg 58:103107, 1992 Maciunas RJ, Galloway RL Jr, Latimer J, et al: An independent application accuracy evaluation of stereotactic frame systems. Stereotact Funct Neurosurg 58:103–107, 1992

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Rohling R, , Munger P, & Hollerbach JM, et al: Comparison of accuracy between a mechanical and an optical tracker for image-guided neurosurgery. J Image Guided Surg 1:3034, 1995 Rohling R, Munger P, Hollerbach JM, et al: Comparison of accuracy between a mechanical and an optical tracker for image-guided neurosurgery. J Image Guided Surg 1:30–34, 1995

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Sandeman DR, , Patel N, & Chandler C, et al: Advances in image-directed neurosurgery: preliminary experience with the ISG Viewing Wand compared with the Leksell G frame. Br J Neurosurg 8:529544, 1994 Sandeman DR, Patel N, Chandler C, et al: Advances in image-directed neurosurgery: preliminary experience with the ISG Viewing Wand compared with the Leksell G frame. Br J Neurosurg 8:529–544, 1994

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Sipos EP, , Tebo SA, & Zinreich SJ, et al: In vivo accuracy testing and clinical experience with the ISG Viewing Wand. Neurosurgery 39:194202, 1996 Sipos EP, Tebo SA, Zinreich SJ, et al: In vivo accuracy testing and clinical experience with the ISG Viewing Wand. Neurosurgery 39:194–202, 1996

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Spetzger U, , Laborde G, & Gilsbach JM: Frameless neuronavigation in modern neurosurgery. Minim Invasive Neurosurg 38:163166, 1995 Spetzger U, Laborde G, Gilsbach JM: Frameless neuronavigation in modern neurosurgery. Minim Invasive Neurosurg 38:163–166, 1995

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Vrionis FD, , Foley KT, & Robertson JH, et al: Use of cranial surface anatomical fiducials for interactive image-guided navigation in the temporal bone: a cadaveric study. Neurosurgery 40:755764, 1997 Vrionis FD, Foley KT, Robertson JH, et al: Use of cranial surface anatomical fiducials for interactive image-guided navigation in the temporal bone: a cadaveric study. Neurosurgery 40:755–764, 1997

    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 2264 512 159
Full Text Views 212 26 0
PDF Downloads 136 6 0
EPUB Downloads 0 0 0