A new application of ultrasound-magnetic resonance multimodal fusion virtual navigation in glioma surgery

作者：Chaofeng Liang, Manting Li, Jin Gong, Baoyu Zhang, Cong Lin, Haiyong He, Ke Zhang, Ying Guo · 发表于：Annals of Translational Medicine · 年份：2019 · DOI：10.21037/atm.2019.11.113 · 被引用次数：26 · 研究领域：Glioma Diagnosis and Treatment、Advanced Neuroimaging Techniques and Applications、Cerebrospinal fluid and hydrocephalus

Background: Long-term survival and high-quality life of patients with gliomas depends on the extent of resection (EOR) and the protection of functional white matter fibers. The navigation system provides precise positioning for surgery based on preoperative magnetic resonance imaging (MRI) but the precision decreases when intraoperative brain drift occurs. Ultrasound (US) can support real-time imaging and correct brain shift. The real-time US-MRI multimodal fusion virtual navigation system (UMNS) is a new technique for glioma surgery. In order to obtain a maximum EOR and functional protection, this study aimed to explore the feasibility, efficiency, and safety of real-time UMNS for glioma surgery, and to evaluate the benefit of the new application by UMNS presetting markers between the tumor and functional white matter fiber surgery. Methods: A retrospective analysis included 45 patients who underwent glioma surgery, 19 patients with only intraoperative US, and 26 patients with UMNS. A preoperative plan was made by 3D-slicer software based on preoperative MRI. This was combined with a reconstruction of diffusion tensor imaging (DTI) that designed the important locations as “warning points” between functional white matter fibers and tumor. Following patient registration, markers were injected into preset “warning points” under image-guided UMNS in order to give us a warning during surgery in case of postoperative function deficits. The operating time, volumetric assessment in g...