Microscope-based augmented reality with diffusion tensor imaging and fluorescein in insular glioma resection

Area of Science:

• Neurosurgery
• Medical Imaging
• Surgical Technology

Background:

• Maximal safe resection is the primary goal in treating insular gliomas.
• Visualizing deep-seated tumors and critical white matter tracts presents a surgical challenge.

Purpose of the Study:

• To demonstrate the technical aspects of augmented reality (AR)-assisted microsurgery for insular glioma resection.
• To showcase the combined use of diffusion tensor imaging (DTI) fiber tracking and fluorescein dye (F) for enhanced intraoperative visualization.

Main Methods:

• The study presents a video of a pterional transsylvian approach for gross-total resection of a Berger-Sanai type I+IV high-grade insular glioma.
• Intraoperative augmented reality (AR) integrated diffusion tensor imaging (DTI) fiber tracking and fluorescein dye (F) were utilized.
• Microscope-based visualization of the tumor and adjacent white matter tracts was employed.

Main Results:

• The video details the application of DTI-F and AR in achieving gross-total resection of an insular glioma.
• Successful integration of advanced visualization techniques facilitated tumor removal while preserving critical neural structures.

Conclusions:

• The combination of AR, DTI fiber tracking, and fluorescein dye offers a powerful tool for microscope-based insular glioma surgery.
• This integrated approach aids surgeons in achieving maximal safe resection by improving visualization of the tumor and white matter tracts.