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Bello L, Riva M, Casaceli G, Fava E
Technological Advances in Glioma Surgery
European Association of NeuroOncology Magazine 2011; 1 (1): 13-19

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This Image - Fig. 1a-f: Operating Theatre Fig. 2a-b: DTI-FT
Figure/Graphic 1a-f: Operating Theatre
Example of integration in the operating theatre of various types of imaging in a case of left temporo-insular low-grade glioma: (a) volumetric FLAIR; (b) DTI FT reconstruction of IFO (white) superimposed onto a postcontrast T1-weighted MR image; (c) spots of activation for denomination (in white) obtained with fMRI, superimposed onto FLAIR images; (d) axial and (e) coronal post-contrast-T1 weighted images, and (f) spots of activation for verbal generation (in white) obtained with fMRI, superimposed onto FLAIR images. All these images were loaded into the neuronavigation system, co-registered, and fused together to be available during surgery. Surgery was performed in awake anaesthesia and the patient was continuously submitted to object-naming tests by the neuropsychologist during resection. The green cross indicates a subcortical site where semantic paraphrasia was induced by DES, at this site corresponded to the IFO as indicated in (b) and to the medial deep border of the tumour, as shown by FLAIR images (a).
 
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Figure/Graphic 1a-f: Operating Theatre
Example of integration in the operating theatre of various types of imaging in a case of left temporo-insular low-grade glioma: (a) volumetric FLAIR; (b) DTI FT reconstruction of IFO (white) superimposed onto a postcontrast T1-weighted MR image; (c) spots of activation for denomination (in white) obtained with fMRI, superimposed onto FLAIR images; (d) axial and (e) coronal post-contrast-T1 weighted images, and (f) spots of activation for verbal generation (in white) obtained with fMRI, superimposed onto FLAIR images. All these images were loaded into the neuronavigation system, co-registered, and fused together to be available during surgery. Surgery was performed in awake anaesthesia and the patient was continuously submitted to object-naming tests by the neuropsychologist during resection. The green cross indicates a subcortical site where semantic paraphrasia was induced by DES, at this site corresponded to the IFO as indicated in (b) and to the medial deep border of the tumour, as shown by FLAIR images (a).
 
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