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Intraoperative imaging in neurosurgery MRI, CT and ultrasound
  1. J van Dellen

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    Edited by R L Bernays, H-G Imhof and Y Yonekawa. Published by Springer Wien, Vienna, 2003, pp 144, €88. ISBN 3-211-83835-X

    This book forms part of a series of symposia reported by Springer-Verlag. The topics covered are important and timeous. Most neurosurgical units would be evaluating the need for intraoperative imaging, the options, and possibilities. A factor that emerges is the importance of structure, and indeed then the need for courses and refresher symposia on modern operative anatomy and in particular to fully understand the fibre tracts of the brain. The first section, on interventional MRI, covers systems currently in clinical use and some background development and potential that would be valuable and necessary reading for a unit contemplating the introduction of such technology. The authors are experienced and the contribution significant. The second section deals with the role of intraoperative MRI and glioma surgery. It appears that data are emerging that the use of intraoperative MRI allows for more complete resection and probably a better outcome for patients with this devastating disease. It also gives a description of some of the difficulties that will be encountered when using neuro navigation together with the MRI system. The third section provides thoughtful reflections on the use of intraoperative ultrasound for cranial surgery and a chapter on the use of intraoperative CT scanning for navigation in spinal surgery. The final chapters provide some personal reflections on intraoperative MRI imaging technology and the use of functional MRI, together with a chapter on the cost benefit ratio of the technology. In the postscript Dr Yonekawa again highlights the need for training in basic micro-neurosurgery to continue parallel to the learning of innovative technical developments.

    The book will provide essential reading for heads of service, neurosurgeons with an interest in neuronavigation and intraoperative imaging, and managers who will be faced with requests for the introduction of such equipment. It is a comprehensive and well balanced collection of views and information on this important and emerging topic.