Neurosurgical Perspective of Advances of Care Using IOpMRI & Tractography

Joseph Yuan-Mou Yang^1,2,3
¹Department of Neurosurgery, Neuroscience Advanced Clinical Imaging Service (NACIS), Royal Children's Hospital, Melbourne, Australia, ²Neuroscience Research, Murdoch Children's Research Institute, Melbourne, Australia, ³Department of Paediatrics, University of Melbourne, Melbourne, Australia

Synopsis

The availability of intraoperative MRI (IOpMRI), and diffusion MRI tractography for presurgical planning and intraoperative image guidance have transformed modern neurosurgical practice. Despite so, the imaging techniques utilised clinically often lag behind rapid advances in MRI hardware, and diffusion MRI methods. Thus, clinical translation requires a cautious approach, and a fundamental awareness of such evidence-practice gap. This talk will review the clinical utility of integrating IOpMRI and tractography in neurosurgical practice. Clinical examples will be used to demonstrate the clinical utilities, to highlight the practical nuances and the related clinical impact by showcasing successful surgical outcomes with functional preservation.

Syllabus

Modern neurosurgical practice has benefited enormously from translation of advanced neuroimaging techniques. The availability of intraoperative MRI (IOpMRI) operating rooms, and diffusion MRI tractography for presurgical planning and intraoperative image guidance (also known as neuronavigation) are prime examples of successful research translation into clinical practice. Despite so, the imaging techniques utilised clinically often lag behind rapid advances in MRI hardware and diffusion MRI methods. Thus, clinical translation requires a cautious approach, and a fundamental awareness of such evidence-practice gap by the neurosurgeons and other clinical end-users.

This talk will provide an overview on the clinical utility of integrating IOpMRI and tractography in neurosurgical practice. Clinical case examples from the speaker’s institutional surgical series will be used to demonstrate the clinical utilities, to highlight the practical nuances, and the related clinical impact by showcasing successful surgical outcomes with functional preservation.

By the end of this talk, the attendees will be expected to:

1. Describe the general setups, the clinical indications, and the clinical impacts of utilising IOpMRI in both the glioma and epilepsy brain surgeries
2. Describe the intraoperative brain shift phenomenon, and the impact on intraoperative image guidance accuracy
3. Describe the common clinical scenarios that would benefit from tractography informed presurgical planning and intraoperative image guidance
4. Understand the current state of tractography informed neurosurgical practice, the evidence-practice gap, and the practical nuances of clinical translation
5. Appreciate both the technical and practical challenges of intraoperative tractography reconstruction/segmentation, using intraoperatively acquired diffusion MRI data

Acknowledgements

The speaker would like to acknowledge support from The Royal Children’s Hospital Foundation, Murdoch Children’s Research Institute, The University of Melbourne, Department of Paediatrics, and the Victorian Government’s Operational Infrastructure Support Program.

References

No reference found.

Proc. Intl. Soc. Mag. Reson. Med. 30 (2022)