Abstract
Non-invasive assessment of cognitive importance has been a major challenge for planning of neurosurgical procedures. In the past decade, in vivo brain imaging modalities have been considered for estimating the ‘eloquence’ of brain areas. In order to estimate the impact of damage caused by an access path towards a target region inside of the skull, multi-modal metrics are introduced in this paper. Accordingly, this estimated damage is obtained by combining multi-modal metrics. In other words, this damage is an aggregate of intervened grey matter volume and axonal fibre numbers, weighted by their importance within the assigned anatomical and functional networks. To validate these metrics, an exhaustive search algorithm is implemented for characterising the solution space and visually representing connectional cost associated with a path initiated from underlying points. In this presentation, brain networks are built from resting state functional magnetic resonance imaging (fMRI) and deterministic tractography. their results demonstrate that the proposed approach is capable of refining traditional heuristics, such as choosing the minimal distance from the lesion, by supplementing connectional importance of the resected tissue. This provides complementary information to help the surgeon in avoiding important functional hubs and their anatomical linkages; which are derived from neuroimaging modalities and incorporated to the related anatomical landmarks.
Highlights
Planning an access trajectory towards central nervous system lesions or tumours often demands careful examination of the functional importance for the tissue surrounding the lesion and across the considered path
Physical distance between projected points over the box is reported as Euclidean distance and angle between proposed and routine trajectory is reported as Angular distance
The surgeon can be supplied with anatomical counterparts of multimodal brain networks, without mentally being overloaded with connectome matrix data that does not provide explicit 3D structural information
Summary
Planning an access trajectory towards central nervous system lesions or tumours often demands careful examination of the functional importance for the tissue surrounding the lesion and across the considered path. Failure to assess the impact of tissue damage along the candidate trajectory may result in severe cognitive, perceptual, motor, or language deficits [1]. In order to minimise the damage to the healthy tissue relying on preoperative imaging, one heuristic is to choose the path that minimises the length of the access path [2] or distance from critical vessels [3]. These consideration alone might not be enough. Going through an eloquent area can result in a measurable functional deficit; currently it is difficult to predict the amount of the deficit
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