Localization of epileptogenic zone based on reconstruction of dynamical epileptic network and virtual resection / 生物医学工程学杂志

Drug-refractory epilepsy (DRE) may be treated by surgical intervention. Intracranial EEG has been widely used to localize the epileptogenic zone (EZ). Most studies of epileptic network focus on the features of EZ nodes, such as centrality and degrees. It is difficult to apply those features to the treatment of individual patients. In this study, we proposed a spatial neighbor expansion approach for EZ localization based on a neural computational model and epileptic network reconstruction. The virtual resection method was also used to validate the effectiveness of our approach. The electrocorticography (ECoG) data from 11 patients with DRE were analyzed in this study. Both interictal data and surgical resection regions were used. The results showed that the rate of consistency between the localized regions and the surgical resections in patients with good outcomes was higher than that in patients with poor outcomes. The average deviation distance of the localized region for patients with good outcomes and poor outcomes were 15 mm and 36 mm, respectively. Outcome prediction showed that the patients with poor outcomes could be improved when the brain regions localized by the proposed approach were treated. This study provides a quantitative analysis tool for patient-specific measures for potential surgical treatment of epilepsy.

The impact of virtual hepatectomy and computer-assisted risk analysis on surgical planning and intraoperative strategy for major hepatic resection / 中华肝胆外科杂志

Objectives To evaluate the impact of virtual hepatectomy and computer-assisted risk analysis on surgical planning and intraoperative strategy for major hepatectomy.Methods Twentytwo consecutive patients (17 males and 5 females) were admitted to the hospital from January to December in 2010 for complicated major hepatectomy.CT scanning was performed with 64-MSCT.All the data of imaging were transferred to the Myrian(R) XP-Liver system (IntrasenseR,France).The following steps were undertaken by a radiologist and a surgeon majoring in liver surgery: step 1,image analysis and 3-D reconstruction; step 2,virtual resection and liver volumetry; step 3,computer-assisted risk analysis for hepatic dysfunction,followed by adjustment of the operative planning.Results The three-dimensional reconstruction models of the liver by the Myrian(R) XP-Liver system were visualized.The ideal simulation effect was achieved comparing the virtual imaging with the actual operation.Of the 22 patients who underwent complicated major hepatectomy,complete tumor removal (R0 resection) was achieved in 20 patients.There were 2 patients who received a R1 resection as microscopic tumor cells were found at the cutting margin of the right portal vein and bile duct.No patient died during the hospital stay.After computer-assisted risk analysis,the operative planning and surgical strategies were changed in 6 patients.Conclusions The application of the hepatic three-dimensional reconstruction and virtual hepatectomy using the Myrian(R) XP-Liver system provided important preoperative data for good preoperative planning and intraoperative strategy in complex hepatectomy.