Explore the cutting-edge advancements in neuronavigation for endoscopic skull base surgery and understand the pivotal role of MRI sequences in enhancing surgical precision and outcomes.
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Neuronavigation in endoscopic skull base surgery and the accuracy of different MRI sequences.
Candy et al., J Clin Neurosci 2024
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https://doi.org/10.1016/j.jocn.2024.04.006
This study investigates the impact of MRI sequence type on the accuracy of neuronavigation during endoscopic endonasal surgery. Specifically, it compares the in vivo accuracy of traditional 3D T1 MPRAGE sequences with new high-resolution 3D T1 SPACE sequences, both prone to distortion on 3T magnets, against CT stereotactic localization. Involving 10 patients, the research measured the discrepancy between real and virtual anatomical landmarks during surgery. The findings suggest that the distance between real and virtual data points was slightly lower in SPACE sequences compared to MPRAGE, although the difference was not statistically significant. This indicates that the type of MRI sequence used does not significantly affect neuronavigation accuracy, and current corrective algorithms are adequate. The study highlights that registration error is a more critical factor influencing navigational accuracy and suggests that future research could explore real-time imaging techniques, like endoscopic ultrasound, to potentially mitigate this issue.