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Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study

BACKGROUND: Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. METHODS: To determine the accuracy and utility of image-based preoperative segmentation in sk...

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Autores principales: Dolati, Parviz, Gokoglu, Abdulkerim, Eichberg, Daniel, Zamani, Amir, Golby, Alexandra, Al-Mefty, Ossama
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665134/
https://www.ncbi.nlm.nih.gov/pubmed/26674155
http://dx.doi.org/10.4103/2152-7806.170023
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author Dolati, Parviz
Gokoglu, Abdulkerim
Eichberg, Daniel
Zamani, Amir
Golby, Alexandra
Al-Mefty, Ossama
author_facet Dolati, Parviz
Gokoglu, Abdulkerim
Eichberg, Daniel
Zamani, Amir
Golby, Alexandra
Al-Mefty, Ossama
author_sort Dolati, Parviz
collection PubMed
description BACKGROUND: Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. METHODS: To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured. RESULTS: Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases. CONCLUSION: Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients.
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spelling pubmed-46651342015-12-15 Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study Dolati, Parviz Gokoglu, Abdulkerim Eichberg, Daniel Zamani, Amir Golby, Alexandra Al-Mefty, Ossama Surg Neurol Int Original Article BACKGROUND: Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. METHODS: To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured. RESULTS: Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases. CONCLUSION: Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients. Medknow Publications & Media Pvt Ltd 2015-11-19 /pmc/articles/PMC4665134/ /pubmed/26674155 http://dx.doi.org/10.4103/2152-7806.170023 Text en Copyright: © 2015 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Dolati, Parviz
Gokoglu, Abdulkerim
Eichberg, Daniel
Zamani, Amir
Golby, Alexandra
Al-Mefty, Ossama
Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study
title Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study
title_full Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study
title_fullStr Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study
title_full_unstemmed Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study
title_short Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study
title_sort multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: a prospective pilot study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665134/
https://www.ncbi.nlm.nih.gov/pubmed/26674155
http://dx.doi.org/10.4103/2152-7806.170023
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