intraoperative neuronavigation using diffusion tensor MR tractography for the resection of a deep tumor adjacent to the corticospinal tract

Stereotactic and Functional Neurosurgery
Roman HlatkyIan E McCutcheon

Abstract

Delineation of cerebral white matter tracts using MR tractography adds essential information for planning intracranial surgery. Integrating tractography with intraoperative neuronavigation may reduce the likelihood of new neurological deficits after surgery done to remove tumors adjacent to the projection fibers of eloquent cortex. We report the utility of such integration for the resection of deep (paraventricular) tumors. A 67-year-old male with malignant melanoma underwent stereotactic radiosurgery for a single metastasis within the paraventricular white matter of the right frontal lobe near the corticospinal tract. The lesion doubled in size within 12 months of radiotherapy. Surgical extirpation was performed aided by intraoperative neuronavigation. MR images of the brain including MR tractography and post-contrast T1-weighted sequences were acquired and imported into a neuronavigational workstation. Asymmetric fusion of contrast-enhanced images and tractography was employed to assist in preservation of the integrity of critical white matter tracts during the surgical procedure. Inclusion of tractography in standard imaging protocols for neuronavigational systems may increase the safety of neurosurgical intervention near wh...Continue Reading

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Citations

Apr 22, 2009·European Journal of Medical Research·Jan VesperG Lammering
May 3, 2012·Neuroimaging Clinics of North America·Seung-Koo Lee
Sep 10, 2014·The Neuroradiology Journal·Rasheed Zakaria, Michael D Jenkinson
Mar 17, 2020·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Tim WendeJürgen Meixensberger

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