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  1. Article: Utility of the Polestar N30 low-field MRI system for resecting non-enhancing intra-axial brain lesions.

    Ungar, Lior / Zibly, Zion / Wohl, Anton / Harel, Ran / Hadani, Moshe / Attia, Moshe / Spiegelmann, Roberto / Feldman, Zeev / Zaubermann, Jacob / Knoller, Nachshon / Cohen, Zvi R

    Neurologia i neurochirurgia polska

    2021  Volume 55, Issue 2, Page(s) 202–211

    Abstract: Background: To determine the utility of an intraoperative magnetic resonance imaging (iMRI) system, the Polestar N30, for enhancing the resection control of non-enhancing intra-axial brain lesions.: Materials and methods: Seventy-three patients (60 ... ...

    Abstract Background: To determine the utility of an intraoperative magnetic resonance imaging (iMRI) system, the Polestar N30, for enhancing the resection control of non-enhancing intra-axial brain lesions.
    Materials and methods: Seventy-three patients (60 males [83.3%], mean age 37 years) with intra-axial brain lesions underwent resection at Sheba Medical Centre using the Polestar between February 2012 and the end of August 2018. Demographic and imaging data were retrospectively analysed. Thirty-five patients had a non-enhancing lesion (48%).
    Results: Complete resection was planned for 60/73 cases after preoperative imaging. Complete resection was achieved in 59/60 (98.3%) cases. After iMRI, additional resection was performed in 24/73 (32.8%) cases, and complete resection was performed in 17/60 (28.8%) cases in which a complete resection was intended. In 6/13 (46%) patients for whom incomplete resection was intended, further resection was performed. The extent of resection was extended mainly for non-enhancing lesions: 16/35 (46%) as opposed to only 8/38 (21%) for enhancing lesions. Further resection was not significantly associated with sex, age, intended resection, recurrence, or affected side. Univariate analysis revealed non-eloquent area, intended complete resection, and enhancing lesions to be predictive factors for complete resection, and non-enhancing lesions and scan time to be predictive factors for an extended resection. Non-enhancement was the only independent factor for extended resection.
    Conclusions: The Polestar N30 is useful for evaluating residual non-enhancing intra-axial brain lesions and achieving maximal resection.
    MeSH term(s) Adult ; Brain/diagnostic imaging ; Brain/surgery ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Glioma ; Humans ; Magnetic Resonance Imaging ; Male ; Monitoring, Intraoperative ; Neoplasm Recurrence, Local ; Retrospective Studies
    Language English
    Publishing date 2021-02-09
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 415519-1
    ISSN 1897-4260 ; 0028-3843
    ISSN (online) 1897-4260
    ISSN 0028-3843
    DOI 10.5603/PJNNS.a2021.0017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 739: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Comparison of Frame-Based Versus Frameless Image-Guided Intracranial Stereotactic Brain Biopsy: A Retrospective Analysis of Safety and Efficacy.

    Ungar, Lior / Nachum, Ortal / Zibly, Zion / Wohl, Anton / Harel, Ran / Attia, Moshe / Spiegelmann, Roberto / Zaubermann, Jacob / Feldman, Zeev / Knoller, Nachshon / Cohen, Zvi R

    World neurosurgery

    2021  Volume 164, Page(s) e1–e7

    Abstract: Background: A definitive diagnosis of brain lesions not amenable to surgery is mainly made by stereotactic needle biopsy. The diagnostic yield and safety of the frameless versus frame-based image-guided stereotactic techniques is unclear. Our objective ... ...

    Abstract Background: A definitive diagnosis of brain lesions not amenable to surgery is mainly made by stereotactic needle biopsy. The diagnostic yield and safety of the frameless versus frame-based image-guided stereotactic techniques is unclear. Our objective was to evaluate the safety and accuracy of frameless versus frame-based stereotactic brain biopsy techniques.
    Methods: A total of 278 patients (153 men; mean age: 65.5 years) with intra-axial brain lesions underwent frame-based (n = 148) or frameless image-guided stereotactic brain biopsy (n = 130) using a minimally invasive twist drill technique during 2010-2016 at Sheba Medical Center. Demographic, imaging, and clinical data were retrospectively analyzed.
    Results: The diagnostic yield (>90%) did not differ significantly between groups. Overall morbidity (6.8% vs. 8.5%), incidence of permanent neurologic deficits (2.1% vs. 1.6%), mortality rate (0.7% vs. 0.8%), and postoperative computed tomography-detected asymptomatic (14.2% vs. 16.1%) and symptomatic (2.0% vs. 1.6%) bleeding also did not differ significantly between the frame-based and frameless cohorts, respectively. The diagnostic yield and complication rates related to the biopsy technique were not significantly associated with sex, age, entry angle to the skull and skull thickness, lesion location or depth, or radiologic characteristics. Diagnostic yield was significantly associated with the mean lesion volume. Smaller lesions were less diagnostic than larger lesions in both techniques (P = 0.043 frame-based and P = 0.048 frameless).
    Conclusions: The frameless biopsy technique is as efficient as the frame-based brain biopsy technique with a low complication rate. Lesion volume was the only predictive factor of diagnostic yield. The minimally invasive twist drill technique is safe and efficient.
    MeSH term(s) Aged ; Biopsy/adverse effects ; Biopsy/methods ; Brain/diagnostic imaging ; Brain/pathology ; Brain/surgery ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/pathology ; Brain Neoplasms/surgery ; Humans ; Image-Guided Biopsy ; Male ; Neuronavigation/methods ; Retrospective Studies ; Stereotaxic Techniques
    Language English
    Publishing date 2021-07-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2021.07.063
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Magnetic resonance imaging-guided focused ultrasound for thermal ablation in the brain: a feasibility study in a swine model.

    Cohen, Zvi R / Zaubermann, Jacob / Harnof, Sagi / Mardor, Yael / Nass, Dvora / Zadicario, Eyal / Hananel, Arik / Castel, David / Faibel, Meir / Ram, Zvi

    Neurosurgery

    2007  Volume 60, Issue 4, Page(s) 593–600; discussion 600

    Abstract: Introduction: Magnetic resonance imaging (MRI)-guided focused ultrasound is a novel technique that was developed to enable precise, image-guided targeting and destruction of tumors by thermocoagulation. The system, ExAblate2000, is a focused ultrasound ... ...

    Abstract Introduction: Magnetic resonance imaging (MRI)-guided focused ultrasound is a novel technique that was developed to enable precise, image-guided targeting and destruction of tumors by thermocoagulation. The system, ExAblate2000, is a focused ultrasound delivery system embedded within the MRI bed of a conventional diagnostic MRI scanner. The device delivers small volumetric sonications from an ultrasound phased array transmitter that converge energy to selectively destroy the target. Temperature maps generated by the MRI scanner verify the location and thermal rise as feedback, as well as thermal destruction. To assess the safety, feasibility, and precision of this technology in the brain, we have used the ExAblate system to create predefined thermal lesions in the brains of pigs.
    Methods: Ten pigs underwent bilateral craniectomy to provide a bone window for the ultrasound beams. Seven to 10 days later, the animals were anesthetized and positioned in the ExAblate system. A predefined, 1-cm frontal para ventricular region was delineated as the target and treated with multiple sonications. MRI was performed immediately and 1 week after treatment. The animals were then sacrificed and the brains removed for pathological study. The size of individual sonication points and the location of the lesion were compared between the planned dose maps, posttreatment MRI scans, and pathological specimen.
    Results: High-energy sonications led to precise coagulation necrosis of the specified targets as shown by subsequent MRI, macroscopic, and histological analysis. The thermal lesions were sharply demarcated from the surrounding brain with no anatomic or histological abnormalities outside the target.
    Conclusion: MRI-guided focused ultrasound proved a precise and an effective means to destroy anatomically predefined brain targets by thermocoagulation with minimal associated edema or damage to adjacent structures. Contrast-enhanced T1-, T2-, and diffusion-weighted MRI scans may be used for real-time assessment of tissue destruction.
    MeSH term(s) Animals ; Brain/anatomy & histology ; Brain/physiology ; Brain Diseases/pathology ; Brain Diseases/therapy ; Equipment Design ; Equipment Failure Analysis ; Feasibility Studies ; Hyperthermia, Induced/instrumentation ; Hyperthermia, Induced/methods ; Magnetic Resonance Imaging/instrumentation ; Magnetic Resonance Imaging/methods ; Swine ; Ultrasonic Therapy/instrumentation ; Ultrasonic Therapy/methods
    Language English
    Publishing date 2007-04
    Publishing country United States
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/01.NEU.0000245606.99946.C6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1424: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 539: Show issues

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