Integration of sulcal and functional information for multimodal neuronavigation.
OBJECTIVE
The authors present the use of cortical sulci, segmented from magnetic resonance (MR) imaging, and functional data from functional (f)MR imaging and magnetoencephalography (MEG) in the image-guided surgical management of lesions adjacent to the sensorimotor cortex.


METHODS
In an initial set of 11 patients, sulci near lesions were automatically segmented from MR imaging data sets, then MEG and fMR imaging examinations were performed. Relevant functional information was preoperatively interpreted and selected from MEG and fMR imaging and subsequently transferred to the navigation system for selected sulci. A neuronavigation system consisting of a surgical microscope with enhanced reality overlay display was used. Data were displayed as contours on the cut-plane images of a stereotactic workstation and as contours on the overlay screen of the head-up display within the optical path of the right eyepiece of the surgical microscope.


CONCLUSIONS
This method, in which both sulcal and functional mapping are used for surgery planning and neuronavigation, provides helpful information. It is a promising procedure for the treatment of patients who harbor lesions in areas around the eloquent cortex.
Jannin
Pierre
P
Laboratoire IDM and LRMBM, Faculté de Médecine Univsersité de Rennes, France. pierre.jannin@univ.rennes1.fr
Morandi
Xavier
X
Fleig
Oliver J
OJ
Le Rumeur
Elisabeth
E
Toulouse
Pierre
P
Gibaud
Bernard
B
Scarabin
Jean-Marie
JM
D000328:Adult; D000368:Aged; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D010296:Parietal Lobe / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D011300:Preoperative Care; D013003:Somatosensory Cortex / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted