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Updated: May 9, 2026
A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery
Published on: May 20, 2016
[Integration of metabolism images into multimodal neuronavigation for frameless stereotaxy]
Fang-ye Li1, Xiao-lei Chen, Ting-ting He
1Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Objectives:
To evaluate the efficacy of integration of metabolism images into multimodal neuronavigation for frameless stereotactic biopsy.
Methods:
From January to December 2012, 32 patients with brain lesions underwent frameless stereotactic biopsy guided by positron emission tomograph (PET) and proton magnetic resonance spectroscopy ((1)H-MRS)-based multimodal neuronavigation and intraoperative magnetic resonance imaging (iMRI). The cohort consisted of 16 male and 16 female patients, with a mean age of 45 years (range: 7 - 62 years). Biopsy targets were identified according to PET and (1)H-MRS. Biopsy was performed with Varioguide frameless biopsy system. Diagnostic yield and complications were assessed.
Results:
Metabolism images-based multimodal neuronavigation and iMRI were successfully implemented in all cases. iMRI confirmed accuracy of biopsy targets. All the specimens obtained pathological diagnosis, the diagnostic yield was 100%. In 1 patient, iMRI found small hematoma (< 5 ml), surgical evacuation wasn't needed with intraoperative complication rate 3.1%. With the help of multimodal neuronavigation, no patients had new or worsened neurologic deficits.
Conclusions:
Integration of metabolism images into multimodal neuronavigation provide not only anatomical, but also metabolic and functional information for frameless stereotaxy, increasing diagnostic yield and avoiding postoperative neurologic deficits.
