Int J Comput Assist Radiol Surg - Cerebrovascular segmentation and planning of depth electrode insertion for epilepsy surgery.

Tópicos

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Resumo

RPOSE: Depth electrodes are inserted in the brain to locate the epileptogenic zone without craniotomy, but there is risk of surgical hemorrhage. Preoperative planning is required to mitigate this risk. A preoperative imaging, segmentation and three dimensional (3D) visualization procedure was developed to provide neurosurgeons with cortical and vascular anatomy information for surgical planning and neuronavigation.METHODS: Cerebral vascular imaging was performed with phase-contrast magnetic resonance angiography (PC-MRA). Fuzzy c-means was performed to extract brain parenchyma from the PC-MRA images. A multi-scale vessel enhancement filter and thresholding process were combined to segment the vasculature and suppress background noise in the PC-MRA images. Finally, 3D visualization of the vasculature and cortical structures was implemented using volume rendering.RESULTS: Quantitative and qualitative validation of the vascular segmentation method were done. Using manual vascular segmentation as the gold standard, our method produced a satisfactory result: sensitivity was as high as 90?% at a specificity level of 95?%. Moreover, comparing the 3D visualizations of the vasculature and cortical structure for 4 patients with their respective intraoperative craniotomy photographs showed high levels of similarity.CONCLUSION: A new automated segmentation and visualization procedure provides sufficient and accurate cortical and vascular anatomy information compared to intraoperative photographs. This method has potential to assist neurosurgeons with planning and neuronavigation for depth electrode insertion with avoidance of cerebral hemorrhage.

Resumo Limpo

rpose depth electrod insert brain locat epileptogen zone without craniotomi risk surgic hemorrhag preoper plan requir mitig risk preoper imag segment three dimension d visual procedur develop provid neurosurgeon cortic vascular anatomi inform surgic plan neuronavigationmethod cerebr vascular imag perform phasecontrast magnet reson angiographi pcmra fuzzi cmean perform extract brain parenchyma pcmra imag multiscal vessel enhanc filter threshold process combin segment vasculatur suppress background nois pcmra imag final d visual vasculatur cortic structur implement use volum renderingresult quantit qualit valid vascular segment method done use manual vascular segment gold standard method produc satisfactori result sensit high specif level moreov compar d visual vasculatur cortic structur patient respect intraop craniotomi photograph show high level similarityconclus new autom segment visual procedur provid suffici accur cortic vascular anatomi inform compar intraop photograph method potenti assist neurosurgeon plan neuronavig depth electrod insert avoid cerebr hemorrhag

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