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Construction of brain area risk map for decision making using surgical navigation and motor evoked potential monitoring information

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Surgical 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.

Methods

We 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.

Results

The 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.

Conclusion

The 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.

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Acknowledgements

This research was partly supported by a Grant-in-Aid for Research Activity Start-up from JSPS KAKENHI, Grant Number 20K23349.

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Authors and Affiliations

  1. Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Tokyo, Japan

    Tomoko Yamaguchi, Jun Okamoto, Ken Masamune & Yoshihiro Muragaki

  2. DENSO Corporation, Aichi, Japan

    Toshihiko Koyama & Hideki Okuda

  3. OPExPARK Inc., Tokyo, Japan

    Shigeyuki Suzuki & Hideki Okuda

  4. Department of Neurosurgery, Tokyo Women’s Medical University Hospital, Tokyo, Japan

    Atsushi Kuwano & Taiichi Saito

  5. Center for Advanced Medical Engineering Research & Development, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, 650-0017, Japan

    Tomoko Yamaguchi

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  1. Tomoko Yamaguchi
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  2. Atsushi Kuwano
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  3. Toshihiko Koyama
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  4. Jun Okamoto
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  5. Shigeyuki Suzuki
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  9. Yoshihiro Muragaki
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Corresponding author

Correspondence to Tomoko Yamaguchi.

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Conflict of interest

T. Yamaguchi, A. Kuwano, T. Saito, K. Masamune and Y. Muragaki declare that they have no conflicts of interest. T. Koyama is an employee of DENSO Corporation. J. Okamoto is Vice President and Chief Operations Officer of SONIRE Therapeutics Inc. S. Suzuki is Chief Technical Officer of OPExPARK Inc. H. Okuda is Executive Vice President and Founder of OPExPARK Inc. and an employee of DENSO Corporation.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Yamaguchi, T., Kuwano, A., Koyama, T. et al. Construction of brain area risk map for decision making using surgical navigation and motor evoked potential monitoring information. Int J CARS 18, 269–278 (2023). https://doi.org/10.1007/s11548-022-02752-7

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  • DOI: https://doi.org/10.1007/s11548-022-02752-7

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