Multimodal anatomic, functional, and metabolic brain imaging for tumor resection.
OBJECTIVE
Improvement of neurosurgical techniques with a more detailed description of brain tumors and their functional environment.


METHODS
We performed: (1) anatomical magnetic resonance imaging (MRI) for reference, (2) functional sequences dedicated to the adjacent cortical structures (sensorimotor, visual, language paradigms), and (3) thallium 201 cerebral tomoscintigraphy to visualize active tumor invasion. Data were transferred to a workstation for automatic registration.


RESULTS
All data were combined into one synthetic image showing the foci of high proliferative activity, which have to be completely resected, and the peritumoral functional structures, which have to be spared in order to minimize postoperative sequelae. This trimodal image is entered into a surgical neuronavigation computer for preoperative planning in order to outline tumoral target and functional risk areas. All this information is displayed in the operative microscope (Zeiss MKM) optically linked to MR images. This multimodality technique diminishes operative time by reducing electrocorticography and improves the operative short-term outcome.


CONCLUSIONS
Multimodal imaging is useful for optimization of neurosurgical tumor resection.
Sabbah
P
P
Radiology, Hôpital du Val de Grâce, 74 Bd Port Royal, 75230 Paris, France. sabbaherv@mail.pf
Foehrenbach
H
H
Dutertre
G
G
Nioche
C
C
DeDreuille
O
O
Bellegou
N
N
Mangin
J F
JF
Leveque
C
C
Faillot
T
T
Gaillard
J F
JF
Desgeorges
M
M
Cordoliani
Y S
YS
D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D005909:Glioblastoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D009837:Oligodendroglioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes