術中MRI撮影のための受信コイル機能を有する定位脳手術装置に関する研究

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Image-guided stereotactic biopsy of a deep brain tumor is a surgical procedure in which the biopsy needle is guided with pinpoint precision to the target based on pre-operative images using a frame-based stereotactic system. Positioning error of the biopsy needle occurs because of intraoperative brain shift or poor imaging properties of the modalities used (e. g. poor soft tissue contrast between tumor and normal tissues, image distortion). The former error can be minimized by using intraoperative images, and the latter by a low magnetic field MRI system that produces better soft tissue contrast with less image distortion than that of a high magnetic field MRI system. MRI-guided stereotaxy based on intraoperative imaging requires both a receiver coil with high diagnostic performance and a conventional stereotactic system allowing uninterrupted MRI scanning. We developed a stereotactic coil which serves both as a radiofrequency receiver coil for intraoperative MR imaging, and as a stereotactic frame. This integrated coil provided adequate soft tissue contrast images for intraoperative diagnosis in a clinical trial. Using the integrated coil we built an intraoperative biopsy system. During experimental testing, biopsy needle positioning error, based on T2-weighed images obtained at the magnetic field center, was 0.2 mm. In a clinical trial, positioning error between the estimated target center and the actual position was 0.93 mm. Thus, this system could work as a stereotactic surgical apparatus. We conclude that our system would be clinically useful and functional, allowing integration of intraoperative MR imaging and stereotactic needle biopsy.

術中MRI撮影のための受信コイル機能を有する定位脳手術装置に関する研究

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