Construction of brain area risk map for decision making using surgical navigation and motor evoked potential monitoring information
Construction of brain area risk map for decision making using surgical navigation and motor evoked potential monitoring information
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使用手术导航和运动诱发电位监测信息构建脑区风险图以进行决策
DOI：
10.1007/s11548-022-02752-7
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发表时间：
2022
影响因子：
3
通讯作者：
Muragaki Yoshihiro
中科院分区：
文献类型：
--
作者：
Yamaguchi Tomoko;Kuwano Atsushi;Koyama Toshihiko;Okamoto Jun;Suzuki Shigeyuki;Okuda Hideki;Saito Taiichi;Masamune Ken;Muragaki Yoshihiro
手术设备或系统通常以独立的方式操作，使得难以执行术中解剖和功能信息的集成分析。为了解决这个问题，开发了术中信息集成系统OPeLiNK®。本研究的目的是产生信息的决策使用手术导航和术中监测信息积累在OPeLiNK®database.MethodsWe积累了27例脑肿瘤患者接受切除手术的术中信息，并分析其效用。首先，根据运动诱发电位（MEP）的衰减率和幅度宽度设置术后瘫痪的风险等级。然后，将MEP和导航日志数据合并并绘制在个体大脑的术中磁共振图像上。最后，进行统计参数映射（SPM）转换以生成术后瘫痪的标准脑风险图。此外，我们确定的解剖高风险地区使用地图集和分析的关系，每个设置riskrank.ResultsThe导航日志对应于每个MEP风险等级和解剖高风险地区之间的平均距离显着不同的术后瘫痪，没有术后瘫痪组，除了“安全”。此外，没有观察到SPM转换产生的过度变形，以创建标准的脑风险图。有情况下，没有发生术后瘫痪，即使MEP降低intraoperation.ConclusionThe时间同步的研究数据的可靠性是非常高的。因此，我们创建的风险地图可以报告为在指示风险区域方面起作用。我们的研究结果表明，术后并发症的统计风险可以为每个区域进行脑手术。在未来，将有可能提供手术导航和术中支持，反映所创建的风险地图。
PurposeSurgical devices or systems typically operate in a stand-alone manner, making it difficult to perform integration analysis of both intraoperative anatomical and functional information. To address this issue, the intraoperative information integration system OPeLiNK®was developed. The objective of this study is to generate information for decision making using surgical navigation and intraoperative monitoring information accumulated in the OPeLiNK®database and to analyze its utility.MethodsWe accumulated intraoperative information from 27 brain tumor patients who underwent resection surgery. First, the risk rank for postoperative paralysis was set according to the attenuation rate and amplitude width of the motor evoked potential (MEP). Then, the MEP and navigation log data were combined and plotted on an intraoperative magnetic resonance image of the individual brain. Finally, statistical parametric mapping (SPM) transformation was performed to generate a standard brain risk map of postoperative paralysis. Additionally, we determined the anatomical high-risk areas using atlases and analyzed the relationship with each set risk rank.ResultsThe average distance between the navigation log corresponding to each MEP risk rank and the anatomical high-risk area differed significantly between the with postoperatively paralyzed and without postoperatively paralyzed groups, except for “safe.” Furthermore, no excessive deformation was observed resulting from SPM conversion to create the standard brain risk map. There were cases in which no postoperative paralysis occurred even when MEP decreased intraoperatively, and vice versa.ConclusionThe time synchronization reliability of the study data is very high. Therefore, our created risk map can be reported as being functional at indicating the risk areas. Our results suggest that the statistical risks of postoperative complications can be presented for each area where brain surgery is to be performed. In the future, it will be possible to provide surgical navigation with intraoperative support that reflects the risk maps created.