Clinical Application of an Open-Source 3D Volume Rendering Software to Neurosurgical Approaches

Clinical Application of an Open-Source 3D Volume Rendering Software to Neurosurgical Approaches

Author de Oliveira Santos, Bruno Fernandes Autor UNIFESP Google Scholar
Silva da Costa, Marcos Devanir Autor UNIFESP Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Cavalheiro, Sergio Autor UNIFESP Google Scholar
de Paiva Neto, Manoel Antonio Autor UNIFESP Google Scholar
Lawton, Michael T. Google Scholar
Chaddad-Neto, Feres Autor UNIFESP Google Scholar
Abstract BACKGROUND: Preoperative recognition of the anatomic individualities of each patient can help to achieve more precise and less invasive approaches. It also may help to anticipate potential complications and intra-operative difficulties. Here we describe the use, accuracy, and precision of a free tool for planning microsurgical approaches using 3-dimensional (3D) reconstructions from magnetic resonance imaging (MRI). METHODS: We used the 3D volume rendering tool of a free open-source software program for 3D reconstruction of images of surgical sites obtained by MRI volumetric acquisition. We recorded anatomic reference points, such as the sulcus and gyrus, and vascularization patterns for intraoperative localization of lesions. Lesion locations were confirmed during surgery by intraoperative ultrasound and/or electrocorticography and later by postoperative MRI. RESULTS: Between August 2015 and September 2016, a total of 23 surgeries were performed using this technique for 9 low-grade gliomas, 7 high-grade gliomas, 4 cortical dysplasias, and 3 arteriovenous malformations. The technique helped delineate lesions with an overall accuracy of 2.6 +/- 1.0 mm. 3D reconstructions were successfully performed in all patients, and images showed sulcus, gyrus, and venous patterns corresponding to the intraoperative images. All lesion areas were confirmed both intraoperatively and at the postoperative evaluation. CONCLUSIONS: With the technique described herein, it was possible to successfully perform 3D reconstruction of the cortical surface. This reconstruction tool may serve as an adjunct to neuronavigation systems or may be used alone when such a system is unavailable.
Keywords Computer-assisted neurosurgical procedure
Neuronavigation
Open-source software
Supratentorial neoplasm
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2018
Published in World Neurosurgery. New York, v. 110, p. E864-E872, 2018.
ISSN 1878-8750 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent E864-E872
Origin http://dx.doi.org/10.1016/j.wneu.2017.11.123
Access rights Closed access
Type Article
Web of Science ID WOS:000425856900111
URI https://repositorio.unifesp.br/handle/11600/54185

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