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Anna C Lawson McLean, Steffen K Rosahl
OBJECT: Neurofibromatosis type 2 is an autosomal-dominant disorder caused by a defective gene locus 22q12. Patients with NF2 are prone to develop multiple intracranial neoplasms, such as vestibular schwannomas, meningiomas and schwannomas of other cranial nerves. To date, little is known about the growth dynamics of these tumors. The aim of our study was to investigate a) the median growth rate per year, b) the growth-free intervals, and c) the growth patterns of these tumors. METHODS: Patient records from the regional neurofibromatosis center were evaluated for their suitability in this analysis...
October 21, 2016: World Neurosurgery
Jane Halliday, Ian Kamaly
BACKGROUND: Neuronavigation, the ability to perform real-time intra-operative guidance during cranial and/or spinal surgery, has increased both accuracy and safety in neurosurgery [2]. Cranial navigation of existing surgical instruments using Brainlab requires the use of an instrument adapter and clamp, which in our experience renders an endoscope 'top-heavy', difficult to manipulate, and the process of registration of the adapter quite time-consuming. METHODS: A Brainlab Disposable Stylet was used to navigate fenestration of an entrapped temporal horn in a pediatric case...
October 14, 2016: Acta Neurochirurgica
Ganesh Narayanasamy, Sotirios Stathakis, Alonso N Gutierrez, Evangelos Pappas, Richard Crownover, John R Floyd, Niko Papanikolaou
BACKGROUND: In this treatment planning study, we compare the plan quality and delivery parameters for the treatment of multiple brain metastases using 2 monoisocentric techniques: the Multiple Metastases Element from Brainlab and the RapidArc volumetric-modulated arc therapy from Varian Medical Systems. METHODS: Eight patients who were treated in our institution for multiple metastases (3-7 lesions) were replanned with Multiple Metastases Element using noncoplanar dynamic conformal arcs...
September 9, 2016: Technology in Cancer Research & Treatment
Johnny E Morales, Martin Butson, Scott B Crowe, Robin Hill, J V Trapp
PURPOSE: An experimental extrapolation technique is presented, which can be used to determine the relative output factors for very small x-ray fields using the Gafchromic EBT3 film. METHODS: Relative output factors were measured for the Brainlab SRS cones ranging in diameters from 4 to 30 mm(2) on a Novalis Trilogy linear accelerator with 6 MV SRS x-rays. The relative output factor was determined from an experimental reducing circular region of interest (ROI) extrapolation technique developed to remove the effects of volume averaging...
August 2016: Medical Physics
Katrina A Morris, Allyson Parry, Pieter M Pretorius
OBJECTIVE: To compare the sensitivity of linear and volumetric measurements on MRI in detecting schwannoma progression in patients with neurofibromatosis type 2 on bevacizumab treatment as well as the extent to which this depends on the size of the tumour. METHODS: We compared retrospectively, changes in linear tumour dimensions at a range of thresholds to volumetric tumour measurements performed using Brainlab iPlan(®) software (Feldkirchen, Germany) and classified for tumour progression according to the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) criteria...
September 2016: British Journal of Radiology
Anil Nanda, Tanmoy K Maiti, Shyamal C Bir, Subhas K Konar, Bharat Guthikonda
OBJECTIVE: Olfactory groove meningiomas are often behaviorally silent. Numerous surgical approaches have been described in the literature for successful removal of these meningiomas. Lateral (pterional/ frontolateral) and anterior (bifrontal/ fronto-orbito-basal) approaches with their various modifications remain the two major corridors in resecting them. In this study, we discuss our experience in microsurgical treatment of these tumors at our institution and assess the extent of frontal lobe damage after the resection of tumor...
June 30, 2016: World Neurosurgery
M Worlicek, M Weber, F Zeman, M Wörner, M Schneider, J Grifka, T Renkawitz, B Craiovan
PURPOSE: The purpose of this study was to evaluate the validity of commercially available planning software on plain radiographs after THA compared to CT scans as the gold standard. PATIENTS AND METHODS: In a prospective clinical study, anteroposterior (AP) radiographs and three-dimensional CT scans (3D-CT) were obtained for 121 patients, who underwent minimally invasive, cementless THA with a straight tapered stem, in a lateral decubitus position. For measuring SV, we used digital planning software (TraumaCad 2...
August 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Chiara Negwer, Sebastian Ille, Theresa Hauck, Nico Sollmann, Stefanie Maurer, Jan S Kirschke, Florian Ringel, Bernhard Meyer, Sandro M Krieg
Diffusion tensor imaging fiber tracking (DTI FT) is used to visualize subcortical fiber tracts. Yet, there is no standard at hand to visualize language-involved subcortical fibers reliably. Thus, this study investigates the feasibility of using language-related cortical areas identified via repetitive navigated transcranial magnetic stimulation (rTMS) to seed DTI FT of subcortical language tracts. From 2011 to 2014, 37 patients with left-hemispheric perisylvian lesions were examined. Language-positive rTMS stimulation spots were integrated in the deterministic tractography software (BrainLAB, iPlanNet 3...
June 20, 2016: Brain Imaging and Behavior
Jeffrey P Mullin, Pranay Soni, Sungho Lee, Lara Jehi, Ahsan Moosa Naduvil Valappi, William Bingaman, Jorge Gonzalez-Martinez
BACKGROUND: In some cases of refractory epilepsy, hemispherectomy is the final invasive treatment option. However, predictors of postoperative hemiparesis in these patients have not been widely studied. OBJECTIVE: To investigate how the volumetric analysis of cerebral peduncles and cerebellar hemispheres in patients who have undergone hemispherectomy may determine prognostic implications for postoperative hemiparesis. METHODS: Twenty-two patients who underwent hemispherectomy at our institution were retrospectively included...
September 2016: Neurosurgery
Paola Koenen, Marco M Schneider, Matthias Fröhlich, Arne Driessen, Bertil Bouillon, Holger Bäthis
Axial alignment is one of the main objectives in total knee arthroplasty (TKA). Computer-assisted surgery (CAS) is more accurate regarding limb alignment reconstruction compared to the conventional technique. The aim of this study was to analyse the precision of the innovative navigation system DASH® by Brainlab and to evaluate the reliability of intraoperatively acquired data. A retrospective analysis of 40 patients was performed, who underwent CAS TKA using the iPod-based navigation system DASH. Pre- and postoperative axial alignment were measured on standardized radiographs by two independent observers...
2016: Advances in Orthopedics
G Schiffer, S Goldmann, C Faymonville, L Müller, G Stein
Background: Placing transpedicular screws in the cervical spine is a special challenge for spine surgeons, due to the anatomical features of this part of the spine. During the last 15 years, computer-aided navigation systems have been developed to facilitate this procedure and to make it safer for patients. One option is navigation by intraoperatively acquired data sets with the use of an 3D C-arm. Patients/Material and methods: Our retrospective study evaluates transpedicular screws in the cervical spine placed by 3D C-arm navigation, within a 6 year period in a level 1 trauma centre...
June 13, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Johanna Quick-Weller, Stephanie Lescher, Markus Bruder, Nazife Dinc, Bedjan Behmanesh, Volker Seifert, Lutz Weise, Gerhard Marquardt
Stereotactic biopsies are procedures performed to obtain tumor tissue for diagnostic examinations. Cerebral lesions of unknown entities can safely be accessed and tissue can be examined, resulting in correct diagnosis and according treatment. Stereotactic procedures of lesions in highly eloquent regions such as the brainstem have been performed for more than two decades in our department. In this retrospective study we focus on results, approaches, modalities of anesthesia, and complications. We performed a retrospective analysis of our prospective database, including 26 patients who underwent stereotactic biopsy of the brainstem between April 1994 and June 2015...
September 2016: Journal of Neuro-oncology
Anna C Lawson McLean, Steffen K Rosahl
OBJECTIVES: Volumetric data on the natural growth of intramedullary tumors in patients with neurofibromatosis type 2 (NF2) are rare, but crucial for long-term disease monitoring. Our aim was to evaluate the growth rates and growth patterns of these tumors. PATIENTS AND METHODS: Patient records from the regional neurofibromatosis referral center were evaluated for inclusion in this analysis. Magnetic resonance images of the spine were collected and digitized as necessary...
July 2016: Clinical Neurology and Neurosurgery
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
2016: Journal of Applied Clinical Medical Physics
Kang-Hyun Ahn, Naim Ozturk, Brett Smith, Konstantin V Slavin, Matthew Koshy, Bulent Aydogan
Frame-based stereotactic radiosurgery (SRS) requires fixation of an invasive head ring to ensure accurate targeting. Minimizing waiting time with a fixed head ring is important for patient comfort and satisfaction. We report a practical preplanning solution for the Brainlab iPlan treatment planning system that reduces waiting time by expediting the planning process on treatment day. A water-filled anthropomorphic head phantom was used to acquire a surrogate CT image set for preplanning and fused with patient's MRI, which was obtained before the day of treatment...
2016: Journal of Applied Clinical Medical Physics
Vance Keeling, Sabbir Hossain, Hosang Jin, Ozer Algan, Salahuddin Ahmad, Imad Ali
The purpose of this study is to evaluate patient setup accuracy and quantify indi-vidual and cumulative positioning uncertainties associated with different hardware and software components of the stereotactic radiotherapy (SRS/SRT) with the frameless 6D ExacTrac system. A statistical model is used to evaluate positioning uncertainties of the different components of SRS/SRT treatment with the Brainlab 6D ExacTrac system using the positioning shifts of 35 patients having cranial lesions. All these patients are immobilized with rigid head-and-neck masks, simu-lated with Brainlab localizer and planned with iPlan treatment planning system...
2016: Journal of Applied Clinical Medical Physics
Peng Li, Ming Xuan, Chuhang Liao, Wei Tang, Xiao-Yi Wang, Weidong Tian, Jie Long
BACKGROUND: A microvascular fibular flap is the main option for the reconstruction of mandibular defects. This paper introduces an innovative strategy for the accurate fabrication of fibular flaps. METHODS: Nine patients with mandibular tumors were included in this study. The mandibular reconstruction planning was performed using MIMICS 10.01. One reconstruction plate was preformed. During the operation, the fibular flap was fabricated and implanted using the BrainLab navigation system...
May 2016: Journal of Craniofacial Surgery
Ahmed M Ashour, Samer K Elbabaa, Anthony J Caputy, Cristian Gragnaniello
BACKGROUND: Intraventricular tumors present difficult challenges to the neurosurgeon. Neurosurgeons have begun to explore the possibilities of using the endoscope in the radical resection of solid intraventricular lesions. There is a steep learning curve when dealing with such lesions with an endoscope. OBJECTIVE: The aim of this study was to create a laboratory training model for pathological intraventricular neuroendoscopic surgery guided by the navigation system...
April 21, 2016: World Neurosurgery
P Ballesteros-Zebadúa, O A García-Garduño, O O Galván de la Cruz, A Arellano-Reynoso, J M Lárraga-Gutiérrez, M A Celis
OBJECTIVE: To acknowledge the challenges and limitations of image-guided neurosurgery systems, we compared the application accuracy of two different image registration methods for one commercial system. (VectorVision, BrainLab, Germany). METHODS: We used an anthropomorphic head phantom for radiosurgery and a custom built add-on to simulate surgical targets inside the brain during an image-guided neurosurgery. We used two image registration methods, fiducial registration using attachable surface markers for computed tomography (CT) and surface registration using infrared laser face scanning...
April 21, 2016: British Journal of Neurosurgery
Fanny Martin, Florian Magnier, Lucie Berger, Jessica Miroir, Emmanuel Chautard, Pierre Verrelle, Michel Lapeyre, Julian Biau
BACKGROUND: Benign tumors of the skull base are a challenge when delivering radiotherapy. An appropriate choice of radiation technique may significantly improve the patient's outcomes. Our study aimed to compare the dosimetric results of fractionated stereotactic radiotherapy between non-coplanar dynamic arcs and coplanar volumetric modulated arctherapy (Rapidarc®). METHODS: Thirteen patients treated with Novalis TX® were analysed: six vestibular schwannomas, four pituitary adenomas and three meningioma...
2016: Radiation Oncology
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