Micah Belzberg1,2, Netanel Ben Shalom1,3, Angela Lu1, Edward Yuhanna4, Amir Manbachi3,5, Aylin Tekes6, Judy Huang1,3, Henry Brem1,3, Chad Gordon1,2,3. 1. Multidisciplinary Adult Cranioplasty Center (MACC), Department of Neurosurgery, Johns Hopkins University School of Medicine. 2. Division of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine. 3. Department of Neurosurgery, Johns Hopkins University School of Medicine. 4. Department of Radiology, Johns Hopkins Hospital. 5. Department of Biomedical Engineering, Johns Hopkins University. 6. Division of Pediatric Radiology and Pediatric Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract
BACKGROUND: Current methods of transcranial diagnostic ultrasound imaging are limited by the skull's acoustic properties. Craniotomy, craniectomy, and cranioplasty procedures present opportunities to circumvent these limitations by substituting autologous bone with synthetic cranial implants composed of sonolucent biomaterials. OBJECTIVE: This study examined the potential to image the brain using transcranioplasty ultrasound (TCU) through a sonolucent cranial implant. MATERIALS AND METHODS: A validated adult brain phantom was imaged using computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound without an implant. Next, for experimental comparison, TCU was performed through a sonolucent implant composed of clear polymethyl methacrylate. RESULTS: All imaging modalities successfully revealed elements of the brain phantom, including the bilateral ventricular system, the falx cerebri, and a deep hyperdense mass representing a brain tumor or hematoma. In addition, ultrasound images were captured which closely resembled axial images obtained with both CT and MRI. CONCLUSION: The results obtained in this first-ever, preclinical, phantom study suggest TCU is now a viable immediate and long-term diagnostic imaging modality deserving of further clinical investigation.
BACKGROUND: Current methods of transcranial diagnostic ultrasound imaging are limited by the skull's acoustic properties. Craniotomy, craniectomy, and cranioplasty procedures present opportunities to circumvent these limitations by substituting autologous bone with synthetic cranial implants composed of sonolucent biomaterials. OBJECTIVE: This study examined the potential to image the brain using transcranioplasty ultrasound (TCU) through a sonolucent cranial implant. MATERIALS AND METHODS: A validated adult brain phantom was imaged using computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound without an implant. Next, for experimental comparison, TCU was performed through a sonolucent implant composed of clear polymethyl methacrylate. RESULTS: All imaging modalities successfully revealed elements of the brain phantom, including the bilateral ventricular system, the falx cerebri, and a deep hyperdense mass representing a brain tumor or hematoma. In addition, ultrasound images were captured which closely resembled axial images obtained with both CT and MRI. CONCLUSION: The results obtained in this first-ever, preclinical, phantom study suggest TCU is now a viable immediate and long-term diagnostic imaging modality deserving of further clinical investigation.
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