A5025035801- Meningioma and schwannoma management
- Head and Neck Surgical Oncology
- Glioma Diagnosis and Treatment
- Surgical Simulation and Training
- Cerebrospinal fluid and hydrocephalus
- Intracranial Aneurysms: Treatment and Complications
- Anatomy and Medical Technology
- Pituitary Gland Disorders and Treatments
- Spinal Fractures and Fixation Techniques
- Vascular Malformations Diagnosis and Treatment
- Photoacoustic and Ultrasonic Imaging
- Photodynamic Therapy Research Studies
- Medical Imaging and Analysis
- Medical Imaging Techniques and Applications
- Nanoplatforms for cancer theranostics
- Teratomas and Epidermoid Cysts
- Cardiac, Anesthesia and Surgical Outcomes
- Neurofibromatosis and Schwannoma Cases
- Bone Tumor Diagnosis and Treatments
- Radiomics and Machine Learning in Medical Imaging
- Neurosurgical Procedures and Complications
- Ophthalmology and Eye Disorders
- Spinal Dysraphism and Malformations
- Cerebral Venous Sinus Thrombosis
- Lung Cancer Diagnosis and Treatment
Barrow Neurological Institute
2021-2025
St. Joseph's Hospital and Medical Center
2021-2024
Burdenko Neurosurgery Institute
2017-2022
OBJECTIVE Because gliomas have poorly defined tumor margins, the ability to achieve maximal resection is limited. To better discern these fluorescence-guided surgery has been used aid safe resection. The authors describe their experience with simultaneous use of intraoperative fluorescein sodium (FNa) confocal laser endomicroscopy (CLE) and operating microscope 5-aminolevulinic acid (5-ALA) fluorescence imaging for glioma improve CLE margin discrimination. METHODS FNa 5-ALA wide-field were...
The authors evaluated the feasibility of using first clinical-grade confocal laser endomicroscopy (CLE) system fluorescein sodium for intraoperative in vivo imaging brain tumors.A CLE cleared by FDA was used 30 prospectively enrolled patients with 31 tumors (13 gliomas, 5 meningiomas, 6 other primary tumors, 3 metastases, and 4 reactive tissue). A neuropathologist classified images as interpretable or noninterpretable. Images were compared corresponding frozen permanent histology sections,...
Visualizing and comprehending 3-dimensional (3D) neuroanatomy is challenging. Cadaver dissection limited by low availability, high cost, the need for specialized facilities. New technologies, including 3D rendering of neuroimaging, pictures, videos, are filling this gap facilitating learning, but they also have limitations. This proof-of-concept study explored feasibility combining spatial accuracy reconstructed neuroimaging data with realistic texture fine anatomical details from...
Communication between neurosurgeons and pathologists is mandatory for intraoperative decision-making optimization of resection, especially invasive masses. Handheld confocal laser endomicroscopy (CLE) technology provides in vivo visualization tissue histoarchitecture at cellular resolution. The authors evaluated the feasibility using an innovative surgical telepathology software platform (TSP) to establish real-time, on-the-fly remote communication neurosurgeon CLE pathologist.CLE a TSP were...
The lateral spinal artery (LSA) corresponds to the posterolateral arterial axis of craniocervical junction. Although implicated in various pathologies and injury risks during treatments, existence anatomical characteristics LSA are debated. We aim demonstrate LSA, including its origins, collateral channels, variations. Neurosurgeons performed far-lateral craniotomies cervical laminectomies on 18 cadaver heads (36 sides). Neurovascular structures associated with were examined epidural,...
Objective Confocal laser endomicroscopy (CLE), a handheld imaging technology, provides intraoperative real-time cellular resolution examination of tissue architecture. We evaluated the feasibility and diagnostic capability first clinically approved CLE system for in vivo brain tumors. Methods A total 50 patients who were to undergo tumor surgery prospectively enrolled. images interpreted by one CLE-experienced neuropathologist as lesional, non-lesional, or non-interpretable compared...
Immersive anatomic environments offer an alternative when laboratory access is limited, but current three-dimensional (3D) renderings are not able to simulate the detail and surgical perspectives needed for microsurgical education.To perform a proof-of-concept study of novel photogrammetry 3D reconstruction technique, converting high-definition (monoscopic) images into navigable, interactive, immersive anatomy simulation.Images were acquired from cadaveric dissections open-access...
Objectives Confocal laser endomicroscopy (CLE) is an intraoperative real-time cellular resolution imaging technology that images brain tumor histoarchitecture. Previously, we demonstrated CLE may be interpreted by neuropathologists to determine the presence of infiltration at glioma margins. In this study, assessed neurosurgeons’ ability interpret from margins and compared their assessments those neuropathologists. Methods vivo acquired were previously reviewed CLE-experienced four...
The new US Food and Drug Administration-cleared fluorescein sodium (FNa)-based confocal laser endomicroscopy (CLE) imaging system allows for intraoperative on-the-fly cellular level imaging. Two feasibility studies have been completed with use of this CLE in ex vivo modalities. This study quantitatively compares the image quality diagnostic performance imaging.Images acquired from two prospective clinical studies, one vivo, were analyzed quantitatively. parameters - brightness contrast...
Surgical resection remains the first-line treatment for gliomas. Several fluorescent dyes are currently in use to augment intraoperative tumor visualization, but information on their comparative effectiveness is lacking. We performed systematic assessment of fluorescein sodium (FNa), 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX), and indocyanine green (ICG) fluorescence various glioma models using advanced imaging techniques.Four were used: GL261 (high-grade model), GB3...
OBJECTIVE Microanastomosis is one of the most technically demanding and important microsurgical skills for a neurosurgeon. A hand motion detector based on machine learning tracking technology was developed implemented performance assessment during microvascular anastomosis simulation. METHODS microanastomosis using model capable 21 landmarks without physical sensors attached to surgeon’s hands. Anastomosis procedures were simulated synthetic vessels, recorded with microscope external camera....
Microsurgical training remains indispensable to master cerebrovascular bypass procedures, but simulation models for that accurately replicate microanastomosis in narrow, deep-operating corridors are lacking. Seven scenarios were developed included head various surgical positions with premade approaches, simulating the restrictions of and hand microvascular training. This study describes these assesses their validity.Simulation created using 3D printing skull a designed craniotomy. Brain...
Objective The development of surgical microscope-associated cameras has given rise to a new operating style embodied by hybrid microsurgical and exoscopic operative systems. These platforms utilize specialized camera systems visualize cranial neuroanatomy at various depths. Our study aims understand how different settings in novel exoscope system influence image quality the context neurosurgical procedures. Methods We built an database using captured cadaveric dissection images obtained with...
Background: Fluorescence-guided brain tumor surgery using fluorescein sodium (FNa) for contrast is effective in high-grade gliomas. However, the effectiveness of this technique visualizing noncontrast-enhancing and low-grade gliomas unknown. This report first documented case concurrent use wide-field fluorescence-guided confocal laser endomicroscopy (CLE) with high-dose FNa (40 mg/kg) intraoperative visualization tissue cellularity a nonenhancing glioma. Case Description: A patient underwent...
Fluorescein sodium (FNa) is a fluorescence agent used with wide-field operating microscope for intraoperative guidance and confocal laser endomicroscopy (CLE) to evaluate brain tissue. Susceptibility of FNa degradation over time may affect CLE image quality during prolonged surgeries. This study describes improved characteristics images after redosing FNa.A retrospective analysis was performed using obtained ex vivo from samples tumor resections FNa-based microscope. The comparison groups...
The aim of this study was to assess the surgical use and applicability a biportal bitransorbital approach. Single-portal transorbital combined transnasal approaches have been used in clinical practice, but no has assessed
BACKGROUND: Precise communication between neurosurgeons and pathologists is crucial for optimizing patient care, especially intraoperative diagnoses. Confocal laser endomicroscopy (CLE) combined with a telepathology software platform (TSP) provides novel venue to review CLE images converse intraoperatively in real-time. OBJECTIVE: To describe the feasibility of integrating TSP surgical workflow real-time vivo digital fluorescence tissue imaging 3 patients intracranial tumors. METHODS:...
INTRODUCTION: Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) has proven effective in aiding the detection of glioma marginal zones and enhancing maximal safe resection. FDA-cleared confocal laser endomicroscopy is another imaging modality for intraoperative brain tissue discrimination on cellular level that could improve visualization at margin. METHODS: 5-ALA wide-field CLE were used 9 patients with gliomas (6 enhancing, 3 non-enhancing). was enhanced by use a telesurgical...
Abstract BACKGROUND Aneurysm clipping simulation models are needed to provide tactile feedback of biological vessels in a nonhazardous but surgically relevant environment. OBJECTIVE To describe novel system for aneurysm training and assess its validity. METHODS Craniotomy were fabricated mimic actual tissues movement restrictions experienced during surgery. Turkey wing used create with patient-specific geometry. Three (middle cerebral artery via pterional approach, anterior an...