Localization Of Intracranial Lesions Research Articles

MET-4 ANALYSIS OF METASTATIC BRAIN TUMORS DISCOVERED AT THE SAME TIME AS THE PRIMARY LESION

Abstract Introduction Among metastatic brain tumors, especially in cases where the primary tumor and metastatic brain tumor are found at the same time, it is necessary to consider the priority of treatment for intracranial lesions and the means to obtain a definitive diagnosis. In this study, we performed a statistical analysis on the factors affecting mean survival (mOS) in patients with concurrent primary and metastatic brain tumors. Subjects and Methods A total of 252 patients with metastatic brain tumors treated at our hospital since 2014 were divided into two groups: simul-meta (58 patients) and non-simul-meta (194 patients). Age, sex, primary tumor, number of tumors, presence or absence of metastasis to other organs, localization of intracranial lesions, presence or absence of carcinomatous meningitis, performance status (PS), details of therapeutic intervention (radiation therapy, chemotherapy, surgery). The background factors between the two groups were analyzed using the chi-square test. Factors affecting mOS were evaluated by univariate analysis with log-rank test and multivariate analysis with Cox proportional hazards test. Results In simul-meta and non-simul-meta, mOS was 328 and 295 days, respectively (p=0.864). As a background, lung cancer (76%: 59%; p = 0.02) and surgical intervention group (28%: 11%; p <0.01) were numerous in simul-meta. Good prognostic factors in the simul-meta group extracted by multivariate analysis were surgical intervention and cases of chemotherapy. Chemotherapy cases were stratified into conventional chemotherapy and molecular-targeted drug use, and the prognosis of molecular-targeted cases was better than that of conventional chemotherapy (p=0.01). Discussion In patients with concurrent disease, it is important to complete treatment for intracranial lesions, including surgical treatment, and maintain a general condition that allows chemotherapy to be administered. In addition, considering the frequent occurrence of lung cancer, it is necessary to develop a treatment plan with molecular target therapy in mind.

Localization of Intracranial Lesions Using Superficial Stereotaxic Cranial Lesion Locator Based on Magnetic Resonance Images.

Detection of a deep-seated lesion located in the brain parenchyma and major neuroanatomical sites is a critical issue in neurosurgery. Some neurosurgical cranial navigation systems have been developed that are available; however, some preparation is necessary, including the installation of complex computer software programs and obtaining specific neuroradiological images. The purpose of this experimental study was to design and evaluate a superficial stereotaxic frameless lesion locator in order to localize mass lesions within the brain. A superficial stereotaxic frameless lesion locator system was designed using cardboard and the Cartesian coordinate system as a reference framework. This material was used in a model creating printed magnetic resonance images in the superficially marking of the lesion. This material easily located the lesion placement and superficially projected the lesion location. The results of this study revealed that the superficial stereotaxic frameless lesion location procedure using a coordinate cardboard locator is a safe, fast, and simple procedure. This procedure provides an accurate means of locating the target lesion seated within the brain parenchyma. When compared with other models, we found that this device is reliable and has a high rate of superficial lesion detection. A superficial lesion locator may be used in clinical practice. This experimental study demonstrated the usability and reliability of the procedure. Additional detailed investigations are necessary to improve the procedure.

Presurgical Planning for Supratentorial Lesions with Free Slicer Software and Sina App.

Neuronavigation systems are used widely in the localization of intracranial lesions with satisfactory accuracy. However, they are expensive and difficult to learn. Therefore, a simple and practical augmented reality (AR) system using mobile devices might be an alternative technique. We introduce a mobile AR system for the localization of supratentorial lesions. Its practicability and accuracy were examined by clinical application in patients and comparison with a standard neuronavigation system. A 3-dimensional (3D) model including lesions was created with 3D Slicer. A 2-dimensional image of this 3D model was obtained and overlapped on the patient's head with the Sina app. Registration was conducted with the assistance of anatomical landmarks and fiducial markers. The center of lesion projected on scalp was identified with our mobile AR system and standard neuronavigation system, respectively. The difference in distance between the centers identified by these 2 systems was measured. Our mobile AR system was simple and accurate in the localization of supratentorial lesions with a mean distance difference of 4.4 ± 1.1 mm. Registration added on an average of 141.7 ± 39 seconds to operation time. There was no statistically significant difference for the required time among 3 registrations (P= 0.646). The mobile AR system presents an alternative technology for image-guided neurosurgery and proves to be practical and reliable. The technique contributes to optimal presurgical planning for supratentorial lesions, especially in the absence of a neuronavigation system.

The Assessment of Distortion in Neurosurgical Image Overlay Projection.

Numerous studies have demonstrated the superiority of neuronavigation during neurosurgical procedures compared to non-neuronavigation-based procedures. Limitations to neuronavigation systems include the need for the surgeons to avert their gaze from the surgical field and the cost of the systems, especially for hospitals in developing countries. Overlay projection of imaging directly onto the patient allows localization of intracranial structures. A previous study using overlay projection demonstrated the accuracy of image coregistration for a lesion in the temporal region but did not assess image distortion when projecting onto other anatomical locations. Our aim is to quantify this distortion and establish which regions of the skull would be most suitable for overlay projection. Using the difference in size of a square grid when projected onto an anatomically accurate model skull and a flat surface, from the same distance, we were able to calculate the degree of image distortion when projecting onto the skull from the anterior, posterior, superior, and lateral aspects. Measuring the size of a square when projected onto a flat surface from different distances allowed us to model change in lesion size when projecting a deep structure onto the skull surface. Using 2 mm as the upper limit for distortion, our results show that images can be accurately projected onto the majority (81.4%) of the surface of the skull. Our results support the use of image overlay projection in regions with ≤2 mm distortion to assist with localization of intracranial lesions at a fraction of the cost of existing methods.

CLINICAL ASSESSMENT A SEVERITY OF ACUTE DISLOCATION SYNDROME IN PATIENTS WITH SEVERE BRAIN INJURY

Acute progressive dislocation syndrome is an urgent condition in neurology and neurosurgery and is the main cause of death in patients with severe brain injury (BI). In patients with severe BI and dislocation syndrome regardless the amount, volume and localization of intracranial lesions, we see brain stem compression with typical symptoms of awareness decrease and appearance of secondary symptoms of stem dysfunction which can conceal the signs of focal or hemisphere damage. Frequent and precise functional evaluation of every part of brain stem (middle brain, Pons and medulla oblongata) plays an important role in choosing of surgical intervention and prognosis of treatment outcomes in patients with BI. Proposed by authors Dislocation Syndrome Severance Assessment Scale (DSSAS) is based on measurement / quantitative evaluation of awareness level and function of every part of brain stem. The significance of Dislocation syndrome severance Assessment Scale was assessed on 43 patients with severe BI. We revealed significant correlation between the stage of dislocation syndrome according the DSSAS and the state of basal cisterns, therapeutic approach and outcomes of surgery (p <0,05). Proposed scale can be recommended as additional diagnostic and prognostic tool on pre- and in-hospital treatment stages of patients with severe BI .

Effect of Optical Digitizer Selection on the Application Accuracy of a Surgical Localization System—A Quantitative Comparison between the OPTOTRAK: and FlashPoint Tracking Systems

Application accuracy is a crucial factor for stereotactic surgical localization systems, in which space digitization camera systems are one of the most critical components. In this study we compared the effect of the OPTOTRAK 3020 space digitization system and the FlashPoint Model 3000 and 5000 3D digitizer systems on the application accuracy for interactive localization of intracranial lesions. A phantom was mounted with several implantable frameless markers which were randomly distributed on its surface. The target point was digitized and the coordinates were recorded and compared with reference points. The differences from the reference points represented the deviation from the “true point.” The root mean square (RMS) was calculated to show the differences, and a paired t-test was used to analyze the results. The results with the phantom showed that, for 1-mm sections of CT scans, the RMS was 0.76 ± 0.54 mm for the OPTOTRAK system, 1.23 ± 0.53 mm for the Flash Point Model 3000 3D digitizer system, and 1.00 ± 0.42 mm for the FlashPoint Model 5000 system. These preliminary results snowed that there is no significant difference between the three tracking systems, and, from the quality point of view, they can all be used for image-guided surgery procedures.

Intraoperative real-time ultrasound in the localization of intracranial neoplasms.

Intraoperative ultrasound imaging in the localization of intracranial lesions in eight patients is described. This technique is effective in tumor location, and it can be used throughout surgery to monitor the extent of tumor resection. The ability to locate precisely a deeply situated intracranial lesion intraoperatively can reduce the risk of damage to normal tissue, assist in determining the extent of tumor resection, and reduce the time of surgery. Intraoperative ultrasound holds great promise, but if it is to be used to its fullest extent, further modifications of transducers must be developed.

THE RELIABILITY OF RADIOISOTOPIC ENCEPHALOGRAPHY. A CORRELATION WITH OTHER NEURORADIOLOGICAL AND ANATOMICAL STUDIES.

Brain scans with this diagnostic procedure were used for evaluation of patients suspected of having intracranial neoplasms. The results showed a high degree of accuracy and it is proposed that isotopic encephalography is of equal value as pneumography and angiography in diagnosis and localization of intracranial lesions. The preparation used in brain scintiscanning was Hg/sup 203/-labeled chlormerodrin (Neohydrin); Hg/sup 203/ has physical properties that make it useful in brain scanning. The single line emission of Hg/sup 203/ at 0.28 Mev minimizes scattering. Although Hg/sup 203/ has a longer physical half life than I/sup 131/-labeled human serum albumin, which has been widely used in brain scanning, this objection can be largely overcome by putting the Hg/sup 203/ in the compound chlormerodrin which has a short biological half life. Chlormerodrin is rapidly cleared from the blood, and produces a favorable target- nontarget ratio of activity between the tumor and the brain, which permits earlier scanning than with I/sup 131/-albumin. The kidneys retain about 10% of the chlormerodrin-Hg/sup 203/ with a half life of 28 days, producing a radiation dose of 34 to 40 rad from the usual dose used in brain scanning. To reduce this renal uptake of the radioactive material, 1more » to 1.5 ml of meralluride (Mercuhydrin) is given intramuscularly as a blocking dose the day before administration of chlormerodrin-Hg/sup 203/. The patients were given 600 mu C chloromerodrin-Hg/sup 203/ intravenously approximately 4 hr before scanning. The use of isotopic encephalography for evaluating the results of surgical and radiation therapy in brain tumors was also studied. Several patients showed decreases in the areas of uptake, and others an increased uptake at a time which corresponded with clinical progression of their disease. Small children should not be submitted to this technique because of the radiation the kidneys receive. (BBB)« less

The use of radioactive iodinated serum albumin in the localization of intracranial lesions.

The use of radioactive iodinated serum albumin in the localization of intracranial lesions.

Localization of intracranial lesions by radioactive isotopes.

Localization of intracranial lesions by radioactive isotopes.

RADIOACTIVE ISOTOPES IN LOCALIZATION OF INTRACRANIAL LESIONS

DURING the last three years, a new method for diagnosis and localization of intracranial lesions has been developed.1This method involves the use of radioactive isotopes or compounds tagged with a radioactive isotope, which when given to the patient are taken up preferentially by intracranial lesions. When the calvarium is monitored with a Geiger-Muller counter, a focus of high uptake designating a certain pathological process involving that part of the brain can be obtained. Thus, it is possible to locate the lesion in a majority of patients. For many years, it has been known that the central nervous system possesses a peculiar defense mechanism, the so-called blood-brain barrier (B. B. B.), which protects the system by preventing toxic substances from getting into the nervous tissue. For example, in jaundiced patients, tissues other than that of the central nervous system may be highly tinged with bile pigments; the nervous tissue

The Localization of Intracranial Lesions by Electroencephalography

The Localization of Intracranial Lesions by Electroencephalography

The diagnosis and localization of intracranial lesions. Considered as a research field. Presentation of cases.

The LaryngoscopeVolume 38, Issue 11 p. 693-711 Original CommunicationsFree Access The diagnosis and localization of intracranial lesions. Considered as a research field. Presentation of cases.† Dr. MARVIN F. JONES, New YorkSearch for more papers by this author Dr. MARVIN F. JONES, New YorkSearch for more papers by this author First published: November 1928 https://doi.org/10.1288/00005537-192811000-00001 † Presented as Candidate's Thesis to American Laryngolocal, Rhinological and Otological Society, Washington, D. C., May 3, 1928. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume38, Issue11November 1928Pages 693-711 RelatedInformation

VENOUS ABNORMALITIES AND ANGIOMAS OF THE BRAIN

Essentially all lesions common to the blood vascular system are found in the brain. In an article in a recent number of this journal, 1 the arteriovenous aneurysms or fistulas in the brain were analyzed. In this communication, the venous and capillary tumors, aneurysms and abnormalities will be considered. Although the relative frequency of vascular tumors and aneurysms of the brain is difficult to estimate, the actual number is rapidly increasing, owing to the more intensive development of neurosurgery and of the means by which the accurate diagnosis and localization of intracranial lesions can be made. In a series of about 600 verified tumors of the brain, the vascular tumors and aneurysms of the brain (excluding vascular anomalies) were 5 per cent. Eight of these tumors were arteriovenous; fifteen were referable to the venous and capillary system, and seven were arterial. The vascular lesions most favorable for treatment are those