MURAGAKI Yoshihiro    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Visiting Professor
Language	Japanese
Title	Usefulness of Integration of Preoperative Metabolic Imaging and Intraoperative MRI Navigation System in Glioma Surgery―From the Experience of 78 Positron Emission Tomography Images―
Conference	The 33nd Annual Congress of Japan Society of Computer Aided Surgery
Conference Type	Nationwide Conferences
Presentation Type	Speech
Lecture Type	General
Date	2024/11/10
Holding period	2024/11/08～2024/11/10
Society abstract	日本コンピュータ外科学会誌 26(2),196 2024
Summary	In glioma surgery, intraoperative magnetic resonance imaging（iMRI）is integrated into the navigation system in all cases to achieve both maximum tumor removal with possible preservation of neurological function, and to prevent recurrence and improve prognosis（Ref. 1）. In this study, we report a retrospective evaluation of 78 cases in which preoperative PET metabolic imaging and iMRI were integrated, and the usefulness of this method. The 78 preoperative PET cases（Methionine 77, FDG 1）were localized（43 frontal‒, 17 temporal‒, 12 parietal‒, 2 occipital lobes, 3 insular, 1 thalamus）, 42 left（34 right, 2 bilateral）, 45 male（33 female）, mean 45.1 years, and 60 total（18 awake）. PET‒integrated cases had a preoperative T/N ratio of 3.8, and the pathology results（20‒44 Grade 3‒4 out of 74 cases）showed that this technique was effective for reliable and preferential removal of high‒grade and recurrence‒prone sites. In addition, the recurrent cases（55/78）were difficult to identify the tumor site by the naked eye due to changes in brain structure, and this was helpful in solving the problem. The technique of superimposing iMRI images with high positional accuracy and preoperative metabolic images is the most practical navigation method for intraoperative prediction of metabolic information. Key words：intraoperative MRI, neuro‒navigation, metabolic imaging.