Integrated image- and function-guided surgery in eloquent cortex: a technique report

Int J Med Robot. 2006 Mar;2(1):75-83. doi: 10.1002/rcs.82.

Abstract

The ability to effectively identify eloquent cortex in close proximity to brain tumours is a critical component of surgical planning prior to resection. The use of electrocortical stimulation testing (ECS) during awake neurosurgical procedures remains the gold standard for mapping functional areas, yet the preoperative use of non-invasive brain imaging techniques such as fMRI are gaining popularity as supplemental surgical planning tools. In addition, the intraoperative three-dimensional display of fMRI findings co-registered to structural imaging data maximizes the utility of the preoperative mapping for the surgeon. Advances in these techniques have the potential to limit the size and duration of craniotomies as well as the strain placed on the patient, but more research accurately demonstrating their efficacy is required. In this paper, we demonstrate the integration of preoperative fMRI within a neuronavigation system to aid in surgical planning, as well as the integration of these fMRI data with intraoperative ECS mapping results into a three-dimensional dataset for the purpose of cross-validation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Mapping
  • Brain Neoplasms / physiopathology
  • Brain Neoplasms / surgery*
  • Cerebral Cortex / physiopathology
  • Cerebral Cortex / surgery*
  • Electric Stimulation
  • Female
  • Humans
  • Intraoperative Period
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neuronavigation*
  • Preoperative Care
  • Surgery, Computer-Assisted*
  • Treatment Outcome