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Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study

Safe Trajectory planning for navigation guided biopsy (nBx) of motor eloquent tumours (METs) is important to minimise neurological morbidity. Preliminary clinical data suggest that visualisation of the corticospinal tract (CST) and its relation to the tumour may aid in planning a safe trajectory. In...

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Autores principales: Lalgudi Srinivasan, Harishchandra, Pedro Lavrador, Jose, Tambirajoo, Kantharuby, Pang, Graeme, Patel, Sabina, Gullan, Richard, Vergani, Francesco, Bhangoo, Ranjeev, Shapey, Jonathan, Vasan, Ahilan Kailaya, Ashkan, Keyoumars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051818/
https://www.ncbi.nlm.nih.gov/pubmed/36983649
http://dx.doi.org/10.3390/jpm13030467
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author Lalgudi Srinivasan, Harishchandra
Pedro Lavrador, Jose
Tambirajoo, Kantharuby
Pang, Graeme
Patel, Sabina
Gullan, Richard
Vergani, Francesco
Bhangoo, Ranjeev
Shapey, Jonathan
Vasan, Ahilan Kailaya
Ashkan, Keyoumars
author_facet Lalgudi Srinivasan, Harishchandra
Pedro Lavrador, Jose
Tambirajoo, Kantharuby
Pang, Graeme
Patel, Sabina
Gullan, Richard
Vergani, Francesco
Bhangoo, Ranjeev
Shapey, Jonathan
Vasan, Ahilan Kailaya
Ashkan, Keyoumars
author_sort Lalgudi Srinivasan, Harishchandra
collection PubMed
description Safe Trajectory planning for navigation guided biopsy (nBx) of motor eloquent tumours (METs) is important to minimise neurological morbidity. Preliminary clinical data suggest that visualisation of the corticospinal tract (CST) and its relation to the tumour may aid in planning a safe trajectory. In this article we assess the impact of tractography in nBx planning in a simulation-based exercise. This single centre cross-sectional study was performed in March 2021 including 10 patients with METs divided into 2 groups: (1) tractography enhanced group (T-nBx; n = 5; CST merged with volumetric MRI); (2) anatomy-based group (A-nBx; n = 5; volumetric MRI only). A biopsy target was chosen on each tumour. Volunteer neurosurgical trainees had to plan a suitable biopsy trajectory on a Stealth S8(®) workstation for all patients in a single session. A trajectory safety index (TSI) was devised for each trajectory. Data collection and analysis included a comparison of trajectory planning time, trajectory/lobe changes and TSI. A total of 190 trajectories were analysed based on participation from 19 trainees. Mean trajectory planning time for the entire cohort was 225.1 ± 21.97 s. T-nBx required shorter time for planning (p = 0.01). Mean trajectory changes and lobe changes made per biopsy were 3.28 ± 0.29 and 0.45 ± 0.08, respectively. T-nBx required fewer trajectory/lobe changes (p = 0.01). TSI was better in the presence of tractography than A-nBx (p = 0.04). Neurosurgical experience of trainees had no significant impact on the measured parameters despite adjusted analysis. Irrespective of the level of neurosurgical training, surgical planning of navigation guided biopsy for METs may be achieved in less time with a safer trajectory if tractography imaging is available.
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spelling pubmed-100518182023-03-30 Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study Lalgudi Srinivasan, Harishchandra Pedro Lavrador, Jose Tambirajoo, Kantharuby Pang, Graeme Patel, Sabina Gullan, Richard Vergani, Francesco Bhangoo, Ranjeev Shapey, Jonathan Vasan, Ahilan Kailaya Ashkan, Keyoumars J Pers Med Article Safe Trajectory planning for navigation guided biopsy (nBx) of motor eloquent tumours (METs) is important to minimise neurological morbidity. Preliminary clinical data suggest that visualisation of the corticospinal tract (CST) and its relation to the tumour may aid in planning a safe trajectory. In this article we assess the impact of tractography in nBx planning in a simulation-based exercise. This single centre cross-sectional study was performed in March 2021 including 10 patients with METs divided into 2 groups: (1) tractography enhanced group (T-nBx; n = 5; CST merged with volumetric MRI); (2) anatomy-based group (A-nBx; n = 5; volumetric MRI only). A biopsy target was chosen on each tumour. Volunteer neurosurgical trainees had to plan a suitable biopsy trajectory on a Stealth S8(®) workstation for all patients in a single session. A trajectory safety index (TSI) was devised for each trajectory. Data collection and analysis included a comparison of trajectory planning time, trajectory/lobe changes and TSI. A total of 190 trajectories were analysed based on participation from 19 trainees. Mean trajectory planning time for the entire cohort was 225.1 ± 21.97 s. T-nBx required shorter time for planning (p = 0.01). Mean trajectory changes and lobe changes made per biopsy were 3.28 ± 0.29 and 0.45 ± 0.08, respectively. T-nBx required fewer trajectory/lobe changes (p = 0.01). TSI was better in the presence of tractography than A-nBx (p = 0.04). Neurosurgical experience of trainees had no significant impact on the measured parameters despite adjusted analysis. Irrespective of the level of neurosurgical training, surgical planning of navigation guided biopsy for METs may be achieved in less time with a safer trajectory if tractography imaging is available. MDPI 2023-03-03 /pmc/articles/PMC10051818/ /pubmed/36983649 http://dx.doi.org/10.3390/jpm13030467 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lalgudi Srinivasan, Harishchandra
Pedro Lavrador, Jose
Tambirajoo, Kantharuby
Pang, Graeme
Patel, Sabina
Gullan, Richard
Vergani, Francesco
Bhangoo, Ranjeev
Shapey, Jonathan
Vasan, Ahilan Kailaya
Ashkan, Keyoumars
Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study
title Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study
title_full Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study
title_fullStr Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study
title_full_unstemmed Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study
title_short Tractography-Enhanced Biopsy of Central Core Motor Eloquent Tumours: A Simulation-Based Study
title_sort tractography-enhanced biopsy of central core motor eloquent tumours: a simulation-based study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051818/
https://www.ncbi.nlm.nih.gov/pubmed/36983649
http://dx.doi.org/10.3390/jpm13030467
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