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A High-Throughput Image-Guided Stereotactic Neuronavigation and Focused Ultrasound System for Blood-Brain Barrier Opening in Rodents
Published on: July 16, 2020
Onscreen-guided resection of extra-axial and intra-axial forebrain masses through registration of a variable-suction
Rebecca A Packer1, Stephanie McGrath1
1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.
Objectives:
To describe a novel surgical technique in which neuronavigation is used to guide a tissue resection device during excision of forebrain masses in locations difficult to visualize optically.
Study Design:
Short case series.
Animals:
Six dogs and one cat with forebrain masses (five neoplastic, two nonneoplastic) undergoing excision with a novel tissue resection device and veterinary neuronavigation system.
Methods:
The animals and resection instrument were coregistered to the neuronavigation system. Surgery was guided by real-time onscreen visualization of the resection instrument position relative to the preoperative MR images. Surgical outcome was evaluated by calculating residual tumor volume according to postoperative MRI.
Results:
The technique was technically simple and led to the collection of diagnostic tissue samples in all cases. Postoperative MRI was available in six cases, two with gross-total resection, three with near-total resection, and one with subtotal resection.
Conclusion:
Neuronavigation-guided resection of intra-axial and extra-axial brain masses with the resection device resulted in gross-total or near-total resection in five of six animals with tumors otherwise difficult to visualize. Risk of brain shift limited absolute reliance on navigation images.
Clinical Significance:
Real-time neuronavigation assistance is a feasible method for guidance and successful resection of brain masses that are poorly visualized because of intra-axial or deep location, tumor appearance, or hemorrhage.
Insights
This study introduces a new surgical method using neuronavigation to guide tissue resection for difficult-to-see brain tumors in animals. The technique achieved successful resection in most cases, offering a feasible option for complex brain mass removal.
Area of Science:
- Veterinary neurosurgery
- Surgical navigation technology
- Oncology
Background:
- Excision of forebrain masses can be challenging due to limited optical visualization.
- Accurate guidance is crucial for effective tumor resection and minimizing damage.
Purpose of the Study:
- To describe a novel surgical technique utilizing neuronavigation for tissue resection of forebrain masses.
- To evaluate the feasibility and outcomes of this neuronavigation-guided approach in animals.
Main Methods:
- A case series involving six dogs and one cat with forebrain masses.
- Utilized a novel tissue resection device and a veterinary neuronavigation system.
- Surgery was guided by real-time visualization of the instrument relative to preoperative MRI scans.
Main Results:
- The technique was technically straightforward and yielded diagnostic tissue samples in all cases.
- Postoperative MRI showed gross-total resection in two cases, near-total in three, and subtotal in one.
- Neuronavigation-guided resection achieved gross-total or near-total removal in five of six animals.
Conclusions:
- Neuronavigation-guided resection is a feasible method for brain masses with poor visualization.
- This technique facilitates successful resection of intra-axial and extra-axial brain masses.
- Brain shift is a limitation, requiring careful consideration alongside navigation data.
