title: Preoperative surgical planning for intracranial meningioma resection by virtual reality.
abstract: BACKGROUND
  The Dextroscope system by Volume Interactions (Singapore) had been applied to minimally invasive neurosurgery in many units. This system enables the neurosurgeon to interact intuitively with the three-dimensional graphics in a direct manner resembling the way one communicates with the real objects. In the paper, we explored its values in pre-operation surgical planning for intracranial meningiomas resection.
  
  
  METHODS
  Brain computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) were performed on 10 patients with parasagittal and falcine meningiomas located on central groove area; brain CT, MRI and magnetic resonance angiography (MRA) were performed on 10 patients with anterior skull base meningiomas and 10 patients with sphenoid ridge meningiomas. All these data were transferred to Dextroscope virtual reality system, and reconstructed. Then meningiomas, skull base, brain tissue, drainage vein and cerebral arteries were displayed within the system, and their anatomic relationships were evaluated. Also, the simulation operations were performed.
  
  
  RESULTS
  For parasagittal and falcine meningiomas, the relationships of tumor with drainage vein and superior sagittal sinus were clearly displayed in the Dextroscope system. For anterior skull base and sphenoid ridge meningiomas, the relationships of tumor with bilateral internal carotid arteries, anterior cerebral arteries, middle cerebral arteries and skull base were vividly displayed within the virtual reality system. Surgical planning and simulation operation of all cases were performed as well. The real operations of all patients were conducted according to the simulation with well outcomes.
  
  
  CONCLUSIONS
  According to the virtual reality planning, neurosurgeons could get more anatomic information about meningioma and its surrounding structures, especially important vessels, and choose the best approach for tumor resection, which would lead to better prognosis for patients.
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai 200040, China.
authors.forename: Hai-Liang
authors.initials: HL
authors.lastname: Tang
authors.forename: Hua-Ping
authors.initials: HP
authors.lastname: Sun
authors.forename: Ye
authors.initials: Y
authors.lastname: Gong
authors.forename: Ying
authors.initials: Y
authors.lastname: Mao
authors.forename: Jing-Song
authors.initials: JS
authors.lastname: Wu
authors.forename: Xiao-Luo
authors.initials: XL
authors.lastname: Zhang
authors.forename: Qing
authors.initials: Q
authors.lastname: Xie
authors.forename: Li-Qian
authors.initials: LQ
authors.lastname: Xie
authors.forename: Ming-Zhe
authors.initials: MZ
authors.lastname: Zheng
authors.forename: Dai-Jun
authors.initials: DJ
authors.lastname: Wang
authors.forename: Hong-da
authors.initials: HD
authors.lastname: Zhu
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Tang
authors.forename: Xiao-Yuan
authors.initials: XY
authors.lastname: Feng
authors.forename: Xian-Cheng
authors.initials: XC
authors.lastname: Chen
authors.forename: Liang-Fu
authors.initials: LF
authors.lastname: Zhou
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011859:Radiography