Interactive 3D Map Can Guide Neurologic Surgeons Through the Brain during Procedure

This imaging technology can help surgeons better determine the location of tumors for removal. The 3D mapping also helps guide surgeons during epilepsy procedures to see exactly where electrodes have been placed in the brain and portions of the brain that may have to be removed to help stop seizures.

Neurosurgery is strongly dependent on image guidance, and in order to fully explore the massive amount of data provided by modern imaging devices, neuroscientists and neurosurgeons are steadily asking for improved visualization techniques, said radiologic researcher Song Lai, Ph.D, associate professor of radiology and director of MRI Physics, Jefferson Medical College of Thomas Jefferson University (Philadelphia, PA, USA), whose team developed the software, called MediCAD (computer-assisted diagnosis), over the last few years.

DTI (diffusion tensor imaging) and fMRI (functional MRI) images of the brain are integrated and downloaded, using the MediCAD software, onto personal computers (PCs) in the operating room (OR). This allows the surgeons to view almost real-time digital map of a patient's brain and better perceive brain activity data. MediCAD also allows the surgeons to virtual slice the brain into sections, zoom in for close-ups of sections of the brain and even rotate the image in various directions.

Patients who undergo epilepsy surgery have choice between a number of advanced diagnostic imaging modalities, including MRI, fMRI, DTI, functional connectivity mapped (fc)MRI, positron emission tomography (PET) scanning, and implant electrodes, according to Ashwini Sharan, M.D., neurosurgeon at the Jefferson Comprehensive Epilepsy Center.

As part of this new 3D imaging process, a patient's brain is typically scanned the day before surgery in order to obtain the most up-to-date imaging data. The images are then sent through an electronic archival system known as PACS (picture archiving and communication system) to computers in the OR. The developed software is fast, does not require any pre-processing beyond standard fMRI analysis, and is flexible enough to be incorporated into existing complex medical visualization systems, Dr. Lai noted.


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Jefferson Medical College of Thomas Jefferson University