In the continuous effort to further improve neurosurgery, intraoperative information on structure and function of the brain has become an important tool which potentially will result in an improved outcome of neurosurgical procedures. In this book experts from different countries and neurosurgical organizations have collected information on the state-of-the-art of intraoperative imaging, MRI, CT and ultrasound. Various contributions cover the future of neuroimaging, the impact of intraoperative imaging on glioma surgery, technical and neurosurgical aspects of the different imaging modalities and systems, and economical aspects. The present book thus provides a unique and comprehensive source of information on the complex of intraoperative imaging in modern neurosurgery.

Intraoperative imaging technologies have taken an ever-increasing role in the daily practice of neurosurgeons and the increasing attention and interest necessitated international interaction and collaboration. The Intraoperative Imaging Society was formed in 2007. This book brings together highlights from the second meeting of the Intraoperative Imaging Society, which took place in Istanbul-Turkey from June 14 to 17, 2009. Included within the contents of the book is an overview of the emergence and development of the intraoperative imaging technology as well as a glimpse on where the technology is heading. This is followed by in detail coverage of intraoperative MRI technology and sections on intraoperative CT and ultrasonography. There are also sections on multimodality integration, intraoperative robotics and other intraoperative technologies. We believe that this book will provide an up-to date and comprehensive general overview of the current intraoperative imaging technology as well as detailed discussions on individual techniques and clinical results.

Intraoperative ultrasound is the first and, at present, only direct method available for depicting cerebral structures during neurosurgery. This atlas is a practical introduction to intraoperative ultrasound in neurosurgery and a guide to anatomy and pathomorphological diagnosis. A short introduction to the technical basis of ultrasound is given first. It is followed by instructions for practical application of the method in the operating theater. The next, comprehensive chapter presents various intracranial pathomorphological changes in the ultrasound picture and compares them to the familiar computer tomography and MRI images. A separate chapter deals with individual aspects of actual application during neurosurgical operations: ultrasound biopsy, puncture and endoscopy. This volume is an excellent source of information for the practical application of intraoperative ultrasound.

This book is intended as a practical manual on the use of intraoperative ultrasound (IOUS) as a tool for imaging guidance during cranial and spinal neurosurgical procedures. Full account is taken of the emergence of novel clinical applications and recent technical advances, with extensive coverage of the impact of developments such as improved probe technology, fusion imaging and virtual navigation, 3D ultrasound imaging, contrast-enhanced ultrasound, and elastosonography. Basic principles of ultrasound are elucidated in order to assist in the optimal use of IOUS and clear guidance is provided on the interpretation of imaging findings in various pathologies. Informative comparisons are also made of the use of techniques such as fusion imaging and contrast-enhanced ultrasound in general radiology and neurosurgery. The aim of the authors is to enhance the general knowledge regarding intra-operative ultrasound brain imaging, standardizing its use and exploring new techniques, leading in some way toward compensating the lack of specific training in the application of ultrasound among the neurosurgical community. IOUS is a sensitive tool that can improve surgical precision and help to reduce morbidity.

The definitive reference on intraoperative MR-guided neurosurgery Comprehensive in scope and packed with practical information, Intraoperative MR-Guided Neurosurgery contains detailed coverage of this state-of-the-art technology from the pioneers who developed it. Renowned neurosurgeons and neuroradiologists combine their collective wisdom and experience to demonstrate how MR-guided neuronavigation can be used to view real-time images of a patient's brain during surgery to help remove tumors with greater precision. The authors provide step-by-step descriptions of how to perform procedures, including advice based on their clinical results. Readers will learn about the advantages and drawbacks of the various MR imaging systems, clinical indications for MR-guidance, anesthesia considerations, safety concerns related to working in a magnetic environment, and much more. Features: In-depth coverage of all MR imaging systems helps readers to make informed choices about which technique will best suit their surgical needs Guidelines on the most appropriate imaging sequences for the resection of different types of brain tumors More than 200 high-quality intraoperative photographs taken during actual procedures to orient readers who want to use MRI in the operating room Tips from the experts on safety issues, suitable magnet designs and field strengths, cost and benefit analysis, room design, equipment, and logistics Discussion of other forms of technology that have been combined with intraoperative MR-guidance, such as focused ultrasound, neurosurgical robotics, and other promising innovations This leading-edge text has everything that neurosurgeons, neuroradiologists, and interventionalists need to know to implement an intraoperative MR-guided neurosurgery program.

Currently, surgical management provides the definitive treatment of choice for most pituitary adenomas, craniopharyngiomas and meningiomas of the sellar region. The elegant minimally invasive transnasal endoscopic approach to the sella turcica and the anterior skull base has added a new dimension of versatility to pituitary surgery and can be adapted to many lesions in the region. In this multi-author book with numerous color illustrations the main aspects of the endonasal endoscopic approach to the skull base are presented, starting with a clear description of the endoscopic anatomy, the panoramic view afforded by the endoscope and the development of effective instruments and adjuncts. After the diagnostic studies, the strictly surgical features are considered in detail. The standard technique is described and particular aspects are treated, including the new extended approaches to the cavernous sinus, spheno-ethmoid planum and clival regions. The book stresses the importance of teamwork and has been produced by one of the pioneering groups in the field of endoscopic approaches to the pituitary. It is a useful guide primarily for neurosurgeons and sinonasal endoscopic surgeons but also for other specialists involved in the diagnosis and treatment of skull base lesions.

This book presents a comprehensive overview and outlook for the future of indocyanine green (ICG) fluorescence navigation surgery, which is attracting clinical interest as a safe and less invasive procedure not only in detecting cerebral vessels, coronary arteries, and biliary trees, but also in identifying sentinel lymph nodes in cancer. The book starts with the characteristics of ICG and photodynamic cameras/endoscopes, followed by detailed descriptions of the applications of ICG fluorescence imaging in various areas such as ocular surgery, neurosurgery, cardiovascular surgery, and plastic surgery. It also covers identifying sentinel lymph nodes in breast cancer as well as cancers of the gastrointestinal tract, and provides valuable information for hepato-biliary-pancreatic surgeons, such as identifying tattooing of liver segments and bile leakage. Written entirely by experts in their respective areas, ICG Fluorescence Imaging and Navigation Surgery offers an essential resource for surgeons operating on cancers and vascular disorders in the brain and cardiovascular systems and in plastic surgery.