title: Advanced Image Coregistration within the Leksell Workstation for the Planning of Glioma Surgery: Initial Experience.
abstract: Background Leksell GammaPlan (LGP) and SurgiPlan (ELEKTA Instruments AB, Stockholm, Sweden) may be used effectively for the detailed evaluation of regional neuroanatomy before open neurosurgical procedures. We report our initial experience in the cases of cerebral gliomas. Methods LGP v.8.3 was used before the surgical resection of cerebral gliomas for (1) the delineation of subdural grid electrodes and a detailed evaluation of their position relatively to cortical structures, and (2) for the fusion of structural magnetic resonance imaging and diffusion tensor imaging (DTI) for a detailed visualization of the corticospinal tract (CST) and optic radiation. Results Delineation of the subdural grid within LGP in a patient with seizures caused by left parietal glioma permitted a detailed assessment of the location of electrodes relative to the cortical gyri and sulci and significantly facilitated interpretation of brain mapping before tumor resection. In another patient with parieto-occipital glioma, simultaneous three-dimensional visualization of the tumor, CST, and optic radiation with the use of LGP permitted us to perform tumor resection without postoperative neurologic complications. Finally, incorporation of DTI into SurgiPlan resulted in precise planning of stereotactic biopsy for bilateral thalamic glioma. Conclusion The possibility for detailed evaluation of regional neuroanatomy based on various images within LGP and SurgiPlan may facilitate effective and safe surgical management of intracranial gliomas.
authors.affiliation: Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan ; Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Tamura
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Konishi
authors.forename: Noriko
authors.initials: N
authors.lastname: Tamura
authors.forename: Jean
authors.initials: J
authors.lastname: Regis
authors.forename: Jean François
authors.initials: JF
authors.lastname: Mangin
authors.forename: Takaomi
authors.initials: T
authors.lastname: Taira
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Okada
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iseki
keywords: Leksell GammaPlan; Leksell SurgiPlan; brain tumor surgery; diffusion tensor imaging; gamma knife surgery; image coregistration