Tumour remover

A new technology involving the fusion of four different types of images into a 3D map of a patient’s brain has helped University of Cincinnati (UC) specialists successfully remove a fist-sized tumour from the brain of an Indiana woman.

The surgery was performed at the university hospital by an eight-member team from the Brain Tumor Center at the UC Neuroscience Institute.

Since early 2007, Brain Tumor Center specialists have used the fusion of three types of imaging as a guide to stereotactic surgery.

These include magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI).

In this latest development, however, Dr James Leach, the associate professor of neuroradiology at UC, added computed tomography angiography (CTA), which provides a map of blood vessels (arteries and veins).

Dr Leach processed the images, highlighting the location of speech and movement areas, white-matter tracts and arteries and veins.

He also highlighted the tumour location, then imported all of the information into BrainLAB’s navigation software at the university hospital.

By revealing the tumour’s relationship to all of the functional centres, electrical pathways and arteries and veins in the patient’s brain, the technology enabled Prof John Tew, a neurosurgeon with the Mayfield ClinicTew, and his team to map out a safe pathway to the tumour.

'The ability to completely map the brain and to understand - before we operate - where the tumour lies in relation to important structures is a milestone in our use of digital computer technology to heighten patient safety during complex brain-tumour surgery,' Prof Tew said.

Assisted by the three-dimensional brain-mapping, Tew and his team were able to navigate a trajectory through the patient’s brain and remove 90 per cent of the malignant tumour, an anaplastic astrocytoma, without harming the healthy brain.

The patient was talking normally straight away after surgery and she was walking the halls and able to take a shower without assistance one day after surgery.

The team sought to eradicate the remaining tumour by applying a course of 33 computer-guided, fractionated radiotherapy treatments.