![]() The majority of gliomas (55.1%) are glioblastomas WHO grade IV, which occur with an incidence of 3.4 per 100,000 ( 1). Grade I tumors, typically seen in children, are potentially curable when resected, whereas low-grade gliomas (WHO grade II), which are mostly seen in young adults, progress eventually to high-grade gliomas ( 3). The broad category of gliomas encompasses tumors of astrocytic, oligodendrocytic, or ependymal origin and is classified by the World Health Organization (WHO) into four grades, depending on histological and molecular characteristics ( 2). Gliomas are the most common primary brain tumors representing 27% of all brain and central nervous system (CNS) tumors and 80% of malignant brain tumors in the United States (US) population ( 1). Future implementation of the reconstructed vessel tree into the navigational setup might allow navigational updating with further consecutive increasement of accuracy. ± 1.0 mm, ranging from 2.9 to 6.0 mm.Ĭonclusion: 3D iUS color Doppler allows estimation of brain shift intraoperatively, thus increasing patient safety. Post-resectional mean Euclidean distance was 4.7. Results: Pre-resectional mean Euclidean distance of the marked points was 4.1 ± 1.3 mm (mean ± SD), ranging from 2.6 to 6.0 mm. In each dataset, one to four landmarks were identified, compared to the preoperative MRI, and the Euclidean distance was calculated. Datasets of 3D iUS color Doppler were generated before dural opening and after tumor resection, and the vascular tree was segmented manually. ![]() Intraoperative computed tomography was used for registration. Methods: Six patients suffering from glial tumors located in the temporal lobe were included in this study. Here we describe the visualization of vascular landmarks and their shift during tumor resection using intraoperative navigated 3D color Doppler ultrasound (3D iUS color Doppler). Intraoperative ultrasound has proved to provide excellent live imaging, which may be integrated into the navigational procedure. However, due to brain shift, accuracy decreases with the course of the surgery. To facilitate safe resection, neuronavigational systems are routinely used. 3Center for Mind, Brain and Behavior (CMBB), Marburg, Germanyīackground: In glioma surgery, the patient’s outcome is dramatically influenced by the extent of resection and residual tumor volume.Horst Schmidt Kliniken, Wiesbaden, Germany 2Department of Neurosurgery, Helios Dr.1Department of Neurosurgery, University of Marburg, Marburg, Germany.Benjamin Saß 1*, Mirza Pojskic 1, Darko Zivkovic 1, Barbara Carl 1,2, Christopher Nimsky 1,3 and Miriam H.
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