ADC imaging for intracranial tumor puncture biopsy and tumor level determination

With the development of precision neurosurgery, the surgical intervention under image guidance is more and more applied to neurosurgery, which greatly enhances the surgical effect of neurosurgeryApplications in neurosurgery, from the initial conventional imaging (T1WI, T2WI, T2Flair, and Enhanced T1WI) to advanced magnetic resonance imaging such as DTI, MRS, PWI, and PET, are reported, while applications of diffuse magnetic resonance imaging ADC (epiphoto dispersion coefficient image) images are less reportedChinese, wang Qun,of Neurosurgery,Chen Xiaolei,, etc., wrote that the unit applied ADC-guided puncture biopsy and evaluated the WHO rating of tumors according to ADC values, providing a new auxiliary method for neurosurgery under magnetic resonance imaging guidanceThe article demonstrates the feasibility and reliability of the technology, published in the March 2018 issue of Journal of The Journal of Oncologyretrospective analysis of 60 patients with a puncture biopsy guided by ADC navigation and postoperative pathology diagnosis of glioma S2 and 3To record the FA and ADC values of the puncture target, use iPlan 3.0 (BrainLAB, Germany) to develop a puncture biopsy plan, perform a biopsy under the VarioGuide (BrainLAB, Germany) biopsy system, and use the duringoperative magnetic resonance to confirm the location of the biopsy (Figure 1)Using the pathological results of the puncture biopsy specimen as a gold standard, the subject's working characteristic curve (ROC) was mapped to assess the sensitivity, specificity, accuracy, positive prediction, negative prediction and under-curve area (AUC) of each indicator, and all diagnostic indicators were used to establish a diagnostic prediction model and their diagnostic effectiveness was evaluated (Figure 2)Figure 1ADC images guide the puncture biopsy process (24-year-old male, main complaint headache for half a month)a-c: Preoperative T1, T2, and ADC charts show lesions located on the left-hand tail head; d: Apply Brainlab iplaning 3.0 to convert ADC grayscale maps to pseudo-color slabs; e: Combine ADC pseudo-color maps with T1WI anatomical images (ADC pseudo-color map, low ADC values shown as Hot spot area, marked as red puncture target; f: biopsy plan (piercing path (dark blue) avoids the important side ventricle (light blue), cone beam (purple) and cortical spinal cord beam (orange) to reach the puncture target (red); g-h: T1, T2 image in surgery shows the target puncture successFigure 2The ROC curve shows the diagnostic efficacy of the predictive model, ADC value, and FA values in glioma grading (aUC representation)a: ROC curves for individual ADC and FA values; b: ROC curves of predictive models that integrate ADC values and FA values , the minimum ADC value in the identification of 2 and 3 gliomas has high diagnostic value, combined with ADC value and FA value prediction model also has a certain diagnostic efficacy, but still need further forward-looking research to evaluate At the same time, this study proves the feasibility and accuracy of puncture biopsy under the guidance of ADC, and provides a new method for puncture biopsy under the guidance of neurosurgery imaging (Professor Yang Jia
of neurosurgery , University of Marburg University, Germany, Chinese Professor Chen Xiaolei , Professor Chen Xiaolei, general hospital of the People's Liberation Army, or click on the "
Read the original text " to view the original text .Wang Q, Zhang J, Xu X, et al J Neurooncol, 2018, DOI: 10.1007/s11060-018-2841-5