Abstract
Maximal safe resection is the goal of insular glioma surgery. The combination of intraoperative augmented reality (AR) diffusion tensor imaging (DTI) fiber tracking with fluorescein dye (F) helps achieve this goal throughout a microscope-based visualization of the tumor and white matter fiber tracts.The aim of the present video article was to show the technical key aspects of DTI-F microscope-based AR-assisted surgery during the gross-total resection of an insular Berger-Sanai type I+IV high-grade glioma in a 63-year-old patient, performed through a pterional transsylvian approach.The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID2157
Highlights
0:21 This video article aims to show the technical key aspects of the microscope-based augmented reality (AR) with diffusion tensor imaging (DTI) and fluorescein in insular glioma resection
0:31 A 63-year-old female patient suffered from a progressive decline in learning and memory, and new-onset epilepsy
0:51 The tumor arose at the level of the extreme capsule, and it involved the short and long gyri
Summary
0:21 This video article aims to show the technical key aspects of the microscope-based augmented reality (AR) with diffusion tensor imaging (DTI) and fluorescein in insular glioma resection. 0:45 MRI revealed a right insular Berger-Sanai type I+IV high-grade glioma. 1:18 3D-rendered MRI showed in more detail the anatomical relationships between the tumor, circular sulcus of the insula, and putamen. 1:28 Preoperative DTI fiber tracking showed the spatial distribution of the corticospinal tract, occipitofrontal fasciculus, posterior thalamic peduncle, and optic radiation compared to the tumor.
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