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J Neurol Surg B Skull Base 2021; 82(S 03): e321-e329
DOI: 10.1055/s-0040-1701603
Original Article

CT-MRI Image Fusion-Based Computer-Assisted Navigation Management of Communicative Tumors Involved the Infratemporal-Middle Cranial Fossa

Rong Yang
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Han Lu
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Yang Wang
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Xin Peng
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Chi Mao
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Zhiqiang Yi
5   Department of Neurosurgery, Peking University First Hospital, Beijing, P.R. China
,
Yuxing Guo
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Chuanbin Guo
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
› Author Affiliations Funding This work was supported by the Capital Featured Clinical Application Research Project of Beijing Municipal Science & Technology Commission (Z161100000516043); and the General Program of The National Natural Science Foundation of China (81672664).
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Abstract

Objective Computed tomography (CT) and magnetic resonance imaging (MRI) are crucial for preoperative assessment of the three-dimensional (3D) spatial position relationships of tumor, vital vessels, brain tissue, and craniomaxillofacial bones precisely. The value of CT-MRI-based image fusion was explored for the preoperative assessment, virtual planning, and navigation surgery application during the treatment of communicative tumors involved the infratemporal fossa (ITF) and middle cranial fossa.

Methods Eight patients with infratemporal-middle cranial fossa communicative tumors (ICFCTs) were enrolled in this retrospective study. Plain CT, contrast CT, and MRI image data were imported into a workstation for image fusion, which were used for 3D image reconstruction, virtual surgical planning, and intraoperative navigation sequentially. Therapeutic effect was evaluated through the clinical data analysis of ICFCT patients after CT-MRI image fusion-based navigation-guided biopsy or surgery.

Results High-quality CT-MRI image fusion and 3D reconstruction were obtained in all eight cases. Image fusion combined with 3D image reconstruction enhanced the preoperative assessment of ICFCT, and improved the surgical performance via virtual planning. Definite pathological diagnosis was obtained in all four navigation-guided core needle biopsies. Complete removal of the tumor was achieved with one exception among the seven navigation-guided operations. Postoperative cerebrospinal fluid leakage occurred in one patient with recurrent meningioma.

Conclusion CT-MRI image fusion combined with computer-assisted navigation management, optimized the accuracy, safety, and surgical results for core needle biopsy and surgery of ICFCTs.

Keywords

CT - MRI - image fusion - computer-aided navigation - infratemporal-middle cranial fossa - tumor


Publication History

Received: 13 August 2019

Accepted: 24 December 2019

Article published online:
07 February 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Vellutini EAS, Alonso N, Arap SS. et al. Functional reconstruction of temporomandibular joint after resection of pigmented villonodular synovitis with extension to infratemporal fossa and skull base: a case report. Surg J (N Y) 2016; 2 (03) e78-e82
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Shin M, Shojima M, Kondo K. et al. Endoscopic endonasal craniofacial surgery for recurrent skull base meningiomas involving the pterygopalatine fossa, the infratemporal fossa, the orbit, and the paranasal sinus. World Neurosurg 2018; 112: e302-e312
    CrossrefPubMedGoogle Scholar
  • 3 Yacoub A, Anschuetz L, Schneider D, Wimmer W, Caversaccio M. Minimally invasive lateral endoscopic multiport approach to the infratemporal fossa: a cadaveric study. World Neurosurg 2018; 112: e489-e496
    CrossrefPubMedGoogle Scholar
  • 4 Guo YX, Sun ZP, Liu XJ, Bhandari K, Guo CB. Surgical safety distances in the infratemporal fossa: three-dimensional measurement study. Int J Oral Maxillofac Surg 2015; 44 (05) 555-561
    CrossrefPubMedGoogle Scholar
  • 5 Hayashi N, Kurimoto M, Hirashima Y. et al. Efficacy of navigation in skull base surgery using composite computer graphics of magnetic resonance and computed tomography images. Neurol Med Chir (Tokyo) 2001; 41 (07) 335-339
    CrossrefPubMedGoogle Scholar
  • 6 Bell RB. Computer planning and intraoperative navigation in cranio-maxillofacial surgery. Oral Maxillofac Surg Clin North Am 2010; 22 (01) 135-156
    CrossrefPubMedGoogle Scholar
  • 7 Abi-Jaoudeh N, Kruecker J, Kadoury S. et al. Multimodality image fusion-guided procedures: technique, accuracy, and applications. Cardiovasc Intervent Radiol 2012; 35 (05) 986-998
    CrossrefPubMedGoogle Scholar
  • 8 Wei B, Sun G, Hu Q, Tang E. The safety and accuracy of surgical navigation technology in the treatment of lesions involving the skull base. J Craniofac Surg 2017; 28 (06) 1431-1434
    CrossrefPubMedGoogle Scholar
  • 9 Terpolilli NA, Rachinger W, Kunz M. et al. Orbit-associated tumors: navigation and control of resection using intraoperative computed tomography. J Neurosurg 2016; 124 (05) 1319-1327
    CrossrefPubMedGoogle Scholar
  • 10 Nemec SF, Donat MA, Mehrain S. et al. CT-MR image data fusion for computer assisted navigated neurosurgery of temporal bone tumors. Eur J Radiol 2007; 62 (02) 192-198
    CrossrefPubMedGoogle Scholar
  • 11 Choi HY, Yoon DY, Kim ES. et al. Diagnostic performance of CT, MRI, and their combined use for the assessment of the direct cranial or intracranial extension of malignant head and neck tumors. Acta Radiol 2019; 60 (03) 301-307
    CrossrefPubMedGoogle Scholar
  • 12 Zhang SX, Han PH, Zhang GQ. et al. Comparison of SPECT/CT, MRI and CT in diagnosis of skull base bone invasion in nasopharyngeal carcinoma. Biomed Mater Eng 2014; 24 (01) 1117-1124
    PubMedGoogle Scholar
  • 13 Le Y, Chen Y, Zhou F, Liu G, Huang Z, Chen Y. Comparative diagnostic value of 18F-fluoride PET-CT versus MRI for skull-base bone invasion in nasopharyngeal carcinoma. Nucl Med Commun 2016; 37 (10) 1062-1068
    CrossrefPubMedGoogle Scholar
  • 14 Kraeima J, Dorgelo B, Gulbitti HA. et al. Multi-modality 3D mandibular resection planning in head and neck cancer using CT and MRI data fusion: a clinical series. Oral Oncol 2018; 81: 22-28
    CrossrefPubMedGoogle Scholar
  • 15 Inoue HK, Nakajima A, Sato H, Noda SE, Saitoh J, Suzuki Y. Image fusion for radiosurgery, neurosurgery and hypofractionated radiotherapy. Cureus 2015; 7 (03) e252
    PubMedGoogle Scholar
  • 16 Dai J, Wang X, Dong Y, Yu H, Yang D, Shen G. Two- and three-dimensional models for the visualization of jaw tumors based on CT-MRI image fusion. J Craniofac Surg 2012; 23 (02) 502-508
    CrossrefPubMedGoogle Scholar
  • 17 Chiu AG, Palmer JN, Cohen N. Use of image-guided computed tomography-magnetic resonance fusion for complex endoscopic sinus and skull base surgery. Laryngoscope 2005; 115 (04) 753-755
    CrossrefPubMedGoogle Scholar
  • 18 Grosu AL, Lachner R, Wiedenmann N. et al. Validation of a method for automatic image fusion (BrainLAB System) of CT data and 11C-methionine-PET data for stereotactic radiotherapy using a LINAC: first clinical experience. Int J Radiat Oncol Biol Phys 2003; 56 (05) 1450-1463
    CrossrefPubMedGoogle Scholar
  • 19 Bamba Y, Nonaka M, Nakajima S, Yamasaki M. Three-dimensional reconstructed computed tomography-magnetic resonance fusion image-based preoperative planning for surgical procedures for spinal lipoma or tethered spinal cord after myelomeningocele repair. Neurol Med Chir (Tokyo) 2011; 51 (05) 397-402
    CrossrefPubMedGoogle Scholar
  • 20 Thani NB, Bala A, Swann GB, Lind CR. Accuracy of postoperative computed tomography and magnetic resonance image fusion for assessing deep brain stimulation electrodes. Neurosurgery 2011; 69 (01) 207-214
    CrossrefPubMedGoogle Scholar
  • 21 Leong JL, Batra PS, Citardi MJ. CT-MR image fusion for the management of skull base lesions. Otolaryngol Head Neck Surg 2006; 134 (05) 868-876
    CrossrefPubMedGoogle Scholar
  • 22 Guo YX, Peng X, Liu XJ, Zhang L, Yu GY, Guo CB. Application of computer-aided design and navigation technology in skull base and infratemporal fossa tumor surgery [in Chinese]. Zhonghua Kou Qiang Yi Xue Za Zhi 2013; 48 (11) 645-647
    PubMedGoogle Scholar
  • 23 Guo R, Guo YX, Feng Z, Guo CB. Application of a computer-aided navigation technique in surgery for recurrent malignant infratemporal fossa tumors. J Craniofac Surg 2015; 26 (02) e126-e132
    CrossrefPubMedGoogle Scholar
  • 24 Guo Y, Guo C. Maxillary-fronto-temporal approach for removal of recurrent malignant infratemporal fossa tumors: anatomical and clinical study. J Craniomaxillofac Surg 2014; 42 (03) 206-212
    CrossrefPubMedGoogle Scholar
  • 25 Nonaka Y, Fukushima T, Watanabe K, Sakai J, Friedman AH, Zomorodi AR. Middle infratemporal fossa less invasive approach for radical resection of parapharyngeal tumors: surgical microanatomy and clinical application. Neurosurg Rev 2016; 39 (01) 87-96
    CrossrefPubMedGoogle Scholar
  • 26 Xu TF, Duan WC, Lu T, Chen L. Application of three-dimensional reconstruction technique based on CT-MRI fusion in skull base surgery [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 47 (05) 373-378
    PubMedGoogle Scholar
  • 27 Yu HB, Li B, Zhang L, Shen SG, Wang XD. Computer-assisted surgical planning and intraoperative navigation in the treatment of condylar osteochondroma. Int J Oral Maxillofac Surg 2015; 44 (01) 113-118
    CrossrefPubMedGoogle Scholar
  • 28 Azarmehr I, Stokbro K, Bell RB, Thygesen T. Surgical navigation: a systematic review of indications, treatments, and outcomes in oral and maxillofacial surgery. J Oral Maxillofac Surg 2017; 75 (09) 1987-2005
    CrossrefPubMedGoogle Scholar
  • 29 Nemec SF, Peloschek P, Schmook MT. et al. CT-MR image data fusion for computer-assisted navigated surgery of orbital tumors. Eur J Radiol 2010; 73 (02) 224-229
    CrossrefPubMedGoogle Scholar
  • 30 Sato M, Tateishi K, Murata H. et al. Three-dimensional multimodality fusion imaging as an educational and planning tool for deep-seated meningiomas. Br J Neurosurg 2018; 32 (05) 509-515
    CrossrefPubMedGoogle Scholar
  • 31 Han Z, Bondeson JC, Lewis JH. et al. Evaluation of initial setup accuracy and intrafraction motion for spine stereotactic body radiation therapy using stereotactic body frames. Pract Radiat Oncol 2016; 6 (01) e17-e24
    CrossrefPubMedGoogle Scholar
  • 32 Yu Y, Zhang WB, Liu XJ. et al. Three-dimensional image fusion of (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography and contrast-enhanced computed tomography for computer-assisted planning of maxillectomy of recurrent maxillary squamous cell carcinoma and defect reconstruction. J Oral Maxillofac Surg 2017; 75: 1301 , e1301–1301, e1315
    PubMedGoogle Scholar
  • 33 Sekhar LN, Schramm Jr VL, Jones NF. Subtemporal-preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. J Neurosurg 1987; 67 (04) 488-499
    CrossrefPubMedGoogle Scholar