Brain Surgery: Dual-Imaging Technique Is Useful

Brain specialists say the ability to incorporate-in real time-two high-tech imaging tools into the operating room can improve the functional abilities of patients who undergo brain surgery.

Neuroradiologist James Leach, MD, and his University of Cincinnati (UC) colleagues are among the first in the United States to combine functional magnetic resonance imaging (MRI) and "diffusion tensor tractography" data to outline important areas of brain function and their connections prior to surgery-and then transfer that data to the operating room to track those areas during actual surgery. This approach, Leach says, has already been used in 20 cases at Cincinnati's University Hospital. "Combining tractography and functional MRI intraoperatively has been in use clinically for only a few years," says Leach, associate professor of radiology at UC and a neuroradiologist with University Hospital, "but our preliminary data is very promising because it allows us to optimize surgical approaches to treating brain tumours to ultimately improve patient outcomes." He says that combining standard visual, sound, and voice-based tests, whose results are measured by MRI, performed on a high-field-strength (3 Tesla) scanner, with a precise intraoperative guidance system will improve patients' post-operative speech, movement and memory, and also optimize quality of life for those with brain tumours and other neurological conditions. To combine both functional MRI and diffusion tensor tractography images in the operating room, Leach and his colleagues use a high-tech surgical navigation system known as BrainLAB. The BrainLAB technology incorporates functional MRI data to identify brain areas linked to speech, movement and vision, and diffusion tensor imaging data to map critical "white-matter tracts"-the electrical connections between different parts of the brain that should be avoided during surgery. MEDICA.de; Source: University of Cincinnati