Rafael Romero-Garcia1, Yaara Erez2, Geoffrey Oliver3, Mallory Owen4, Sakinah Merali5, Anujan Poologaindran5, Robert C Morris4, Stephen J Price4, Thomas Santarius4, John Suckling5, Michael G Hart6. 1. Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Cambridge, England, United Kingdom; Brain Mapping Unit, Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, England, United Kingdom. 2. MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, England, United Kingdom. 3. Media Studio, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, England, United Kingdom. 4. Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Cambridge, England, United Kingdom. 5. Brain Mapping Unit, Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, England, United Kingdom. 6. Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Cambridge, England, United Kingdom. Electronic address: mgh40@cam.ac.uk.
Abstract
BACKGROUND: A plethora of cutting-edge neuroimaging analyses have been developed and published, yet they have not hitherto been realized as improvements in neurosurgical outcomes. In this paper we propose a novel interface between neuroimaging and neurosurgery for aiding translational research. Our objective is to create a method for applying advanced neuroimaging and network analysis findings to neurosurgery and illustrate its application through the presentation of 2 detailed case vignettes. METHODS: This interface comprises a combination of network visualization, 3-dimensional printing, and ex-vivo neuronavigation to enable preoperative planning according to functional neuroanatomy. Clinical cases were selected from a prospective cohort study. RESULTS: The first case vignette describes a low-grade glioma with potential language and executive function network involvement that underwent a successful complete resection of the lesion with preservation of network features. The second case describes a low-grade glioma in an apparently noneloquent location that underwent a subtotal resection but demonstrated unexpected and significant impairment in executive function postoperatively that subsequently abated during follow-up. In both examples the neuroimaging and network data highlight the complexity of the surrounding functional neuroanatomy at the individual level, beyond that which can be perceived on standard structural sequences. CONCLUSIONS: The described interface has widespread applications for translational research including preoperative planning, neurosurgical training, and detailed patient counseling. A protocol for assessing its effectiveness and safety is proposed. Finally, recommendations for effective translation of findings from neuroimaging to neurosurgery are discussed, with the aim of making clinically meaningful improvements to neurosurgical practice.
BACKGROUND: A plethora of cutting-edge neuroimaging analyses have been developed and published, yet they have not hitherto been realized as improvements in neurosurgical outcomes. In this paper we propose a novel interface between neuroimaging and neurosurgery for aiding translational research. Our objective is to create a method for applying advanced neuroimaging and network analysis findings to neurosurgery and illustrate its application through the presentation of 2 detailed case vignettes. METHODS: This interface comprises a combination of network visualization, 3-dimensional printing, and ex-vivo neuronavigation to enable preoperative planning according to functional neuroanatomy. Clinical cases were selected from a prospective cohort study. RESULTS: The first case vignette describes a low-grade glioma with potential language and executive function network involvement that underwent a successful complete resection of the lesion with preservation of network features. The second case describes a low-grade glioma in an apparently noneloquent location that underwent a subtotal resection but demonstrated unexpected and significant impairment in executive function postoperatively that subsequently abated during follow-up. In both examples the neuroimaging and network data highlight the complexity of the surrounding functional neuroanatomy at the individual level, beyond that which can be perceived on standard structural sequences. CONCLUSIONS: The described interface has widespread applications for translational research including preoperative planning, neurosurgical training, and detailed patient counseling. A protocol for assessing its effectiveness and safety is proposed. Finally, recommendations for effective translation of findings from neuroimaging to neurosurgery are discussed, with the aim of making clinically meaningful improvements to neurosurgical practice.
Authors: Anujan Poologaindran; Christos Profyris; Isabella M Young; Nicholas B Dadario; Syed A Ahsan; Kassem Chendeb; Robert G Briggs; Charles Teo; Rafael Romero-Garcia; John Suckling; Michael E Sughrue Journal: Sci Rep Date: 2022-02-23 Impact factor: 4.379
Authors: Rafael Romero-Garcia; Mallory Owen; Alexa McDonald; Emma Woodberry; Moataz Assem; Pedro Coelho; Rob C Morris; Stephen J Price; Tom Santarius; John Suckling; Tom Manly; Yaara Erez; Michael G Hart Journal: Acta Neurochir (Wien) Date: 2022-03-01 Impact factor: 2.816