Image-guided surgery and therapy

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Image-guided surgery and therapy

Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Malaysia
DOI: 10.2349/biij.3.1.e7
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Microsoft Word - Proof - 0723 _pdf_.doc Available online at doi: 10.2349/biij.3.1.e7 biij Biomedical Imaging and Intervention Journal GUEST EDITORIAL Image-guided surgery and therapy TZ Aziz, MBBS, FRCS(SN), MD, D.Med.Sci Oxford Functional Neurosurgery, Nuffield Department of Surgery, University of Oxford, United Kingdom Received 20 October 2006; accepted 25 October 2006 I am pleased to see the publication of this very novel issue. It brings together in one volume the role modern imaging has to play in surgery and radiotherapy. Certainly in functional neurosurgery imaging has transformed the way it is performed. In its first blossoming in the 1950s, patients were fixed in a stereotactic frame, contrast was injected into the ventricles and x-rays were taken of the patient’s head in the frame from AP and lateral projections. One then had to make corrections for the degree of magnification and divergence of the x-ray beam. Following this, the anterior and posterior commissure were identified on the ventriculogram and the mid-commissural point and its co-ordinates calculated. Having done so, the surgeon referred to an atlas based upon cadaveric studies to calculate the position in the frame with the highest probability of hitting the target. In those days, the motor thalamus or pallidum was identified for Parkinson’s disease and tremor [1]. Morbidity after contrast ventriculography was not unusual [2]. Although surgery was effective in abolishing tremor, there were many side effects as the lesions were imprecise by nature. Alleviation of pain with deep brain surgery had even more side effects as the targets, the peri-acqueductal gray area and sensory thalamus, lay in pathways that were also involved in emotion [3]. Deep brain stimulation though studied in the 1950s was never used long term because of technical limitations. Also, with plain x-rays and ven

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