Telemedicine: Intercontinental DTI-based management of brain tumor patients

Brain tumor patients have a risk of postoperative morbidity. Advanced neuroimaging methods such as DTI, fMRI, intraoperative MRI may provide helpful information to minimize postoperative deficits. However, while most modern MR-scanners allow to record DTI and EPI-sequences, not every institution has the capabilities to analyze these images properly. Here, we share are experiences with an intercontinental telemedicine approach in the management of brain tumor patients.

Brain tumor patients receiving craniotomy at Askariyeh-Charity-Hospital in Isfahan routinely undergo preoperative MPRG and Diffusion-tensor MRI investigations. Data is transferred via www from Isfahan to Hannover where image processing is carried out. DTI results are then sent back to Isfahan.

Microsurgery of the patients is guided by this additional information. Three months after surgery, all patients undergo MRI follow-up with the same protocol. Our evaluations show that clinical outcome of the patients is improved by this approach.

We plan to extend this collaboration to fMRI protocols but the DTI information used so far has already proven to be essential for surgical planning and outcome.