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3D Visualization of acoustic neurinomas

University of Szeged, Department of Otolaryngology and Head and Neck Surgery University of Szeged, Department of Image Processing and Computer Graphics (1) Sun Microsystems Hungary Ltd. 3D Visualization of acoustic neurinomas.

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3D Visualization of acoustic neurinomas

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  1. University of Szeged, Department of Otolaryngology and Head and Neck Surgery University of Szeged, Department of Image Processing and Computer Graphics (1) Sun Microsystems Hungary Ltd. 3D Visualization of acoustic neurinomas JGKiss, AL Nagy, J. Jarabin, A. Tanács, A. Czesznak (1), Gy. Smehák, F. Tóth, L. Rovó, J. Jóri 2009

  2. Acoustic neurinoma: Complications, therapy • Persistent loss of hearing • Icreased intracranial pressure • Erosion of the auditory canal’s wall • Destruction of pons or medulla oblongata • Compression of the cerebellum or a nearby nerve • Some larger tumours may be supratentorial • Therapy: microsurgical, neurosurgical, or stereotaxial irradiation

  3. Objectives of our study • Comparison of the audiological findings of patients with acoustic neurinoma • Investigate possibilities to visualise the objects in 3D • Localisation and visualisation of the tumour

  4. Patients • 10 females, 4 males • Age: 47, 15 ± 13 yrs (25-63)‏ • Statistics: Student’s T-test

  5. Right side Left side DP-level Noise level Methods • pure tone audimoetry • Tympanogram • Stapedius-reflex test • DPOAE • EABR • 3D Slicer (volume measurement)‏

  6. Slicer • Free • Open source • Is being actively developed • Multiplatform (Solaris (x86, x64), linux (x86, x64), MacOS (x86, ppc), Win32 • Intuitive user interface • Very responsive and helpful developer community • Runs on commodity hardware • Website: www.slicer.org

  7. National Cancer Institute National Center for Research Resources National Institute of Biomedical Imaging and Bioengineering Telemedicine & Advanced Technology Research Center of the US Army National Institutes of Health Neuroimaging Analysis Center National Alliance for Medical Image Computing National Center for Image Guided Therapy Biomedical Informatics Research Network Center for Integration of Medicine and Innovative Technology Surgical Planning Laboratory Johns Hopkins University CISST Massachusetts Institute of Technology Georgia Institute of Technology Isomics, Inc. The Martinos CenterMassachusetts General Hospital Kitware, Inc. GE Global Research Harvard NeuroDiscovery Center Scientific Computing and Imaging Institute Psychiatric Neuroimaging Laboratory Major Sponsors and Contributors http://slicer.org/pages/Acknowledgments

  8. Patient 1 Left side Right side

  9. Skull MRI: 16x17x21mm Volume measured with Slicer: 2138 mm3

  10. Patient 2 Right side Left side

  11. Skull MRI: 10x4x27 mm acoustic neurinoma Volume measured with Slicer 1097mm3. Volume is actually about half!

  12. Patient 3 Left side Right side

  13. A 10x8x8 mm neurinoma measured with Slicer: 616 mm3

  14. Patient 4Acoustic neurinoma and two fronto-temporal arachnoidal cysts

  15. Patient 4Acoustic neurinoma and two fronto-temporal arachnoidal cysts Skull MRI: 16x17x21 mm acoustic neurinoma Volume measured with Slicer 1689 mm3 Cysts: 36582 mm3 Legend: grey: cerebellum; light green: grey matter; light blue: cysts; dark blue: neurinoma; light yellow: air; yellow: n. VIII; pink: inner ear; orange: eye muscles; green: eyeball

  16. Pure tone audiometry of the affected and the non affected side Affected side Healthy side Standard deviation: 24,3 Standard deviation: 14,3 1 of our patients had profound hearing loss on both ears

  17. Pure tone audiometry on affected and non-affected ears * * * * * * *: p < 0,05

  18. Stapedius-reflex 10 of our patients had no Stapedius-reflex

  19. EABR, both sides * * * * * * *: p < 0,05

  20. DP intensity, both ears * * * * * * *: p < 0,05

  21. DP-NF intensity, both ears * * * * * * *: p < 0,05

  22. Conclusion • During our work we have found significant differences in: • In the latencies of all the EABR waves between the affected and the non-affected ears • In the IPL of I-III and I-IV/V EABR waves • DPOAE: outer hair cell activity between the affected and the non-affected ears • Pure tone threshold between the affected and the non-affected ears Using Slicer we are able to localize and visualize the exact location and dimensions of the acoustic neurinoma. This can help us to define a more precise prognosis for the patient. With the help of Slicer, the surgical procedure, or the irradiation can be planned very precisely and thus the chances are much higher for a complication-free recovery.

  23. Thank you for you kind attention!

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