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Vectorvision2

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BrainLab VectorVision2 is a surgical navigation system designed for precision in neurosurgical procedures. It utilizes optical tracking technology to provide real-time spatial information to the surgeon during the operation.

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Lab products found in correlation

Vector vision sky, by Brainlab (2 mentions) Iplan net cranial 3, by Brainlab (2 mentions) Iplan cmf 3, by Brainlab (1 mentions) Brightspeed 16, by Philips (1 mentions) Brilliance ct, by Philips (1 mentions)

5 protocols using vectorvision2

1

Integrating nTMS Data into Neuronavigation

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Intraoperative neuronavigation (Vector Vision 2®, Vector Vision Sky®, or Curve; BrainLAB AG, Feldkirchen, Germany) was used in every case in both the nTMS and the non-nTMS group. nTMS data were included in the neuronavigation system for the nTMS group by exporting nTMS-positive motor areas as DICOM files and importing them to the neuronavigation planning unit (BrainLAB iPlan® Net Cranial 3.0.1; BrainLAB AG, Feldkirchen, Germany). nTMS-positive motor areas were fused to a 3D image set of a T1-weighted 3D gradient echo sequence and FLAIR and defined as objects by simple auto segmentation thus making them available as 3D objects for the intraoperative use, as described earlier (17 (link)). The process of implementing nTMS data into the neuronavigation planning took 2–5 min per patient. The result, including nTMS-based DTI fiber tracking (DTI FT) for visualization of the CST, is shown in Figure 1.
Krieg S.M., Picht T., Sollmann N., Bährend I., Ringel F., Nagarajan S.S., Meyer B, & Tarapore P.E. (2016). Resection of Motor Eloquent Metastases Aided by Preoperative nTMS-Based Motor Maps—Comparison of Two Observational Cohorts. Frontiers in Oncology, 6, 261.
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2

Intraoperative Neuromonitoring in High-Grade Glioma Resection

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Surgical technique did not vary between groups. The resection of all 140 HGG was supported by monopolar DCS in order to monitor the motor system by MEPs as described in earlier reports [12 (link),17 (link),18 (link)].
As a second intraoperative modality, neuronavigation was used throughout (Vector Vision 2®, Vector Vision Sky®, and Curve; BrainLAB AG, Feldkirchen, Germany) in all patients. In the nTMS group, the positive nTMS points were visualized as 3D objects by simple auto segmentation within the neuronavigational data set (BrainLAB iPlan® Net Cranial 3.0.1; BrainLAB AG, Feldkirchen, Germany). Positron emission tomography (PET) was fused and integrated into the data set as well. The inclusion of nTMS data as 3D objects in the neuronavigational planning required about 2 to 5 minutes for each case.
Additional techniques, such as intraoperative MRI or ultrasonography, were not used during surgery, and five-aminolevulinic acid (5-ALA) was only used infrequently dependent on the surgeon`s preoperative decision. However, there was no difference in the usage frequency of 5-ALA between the nTMS and the non-nTMS group.
Krieg S.M., Sollmann N., Obermueller T., Sabih J., Bulubas L., Negwer C., Moser T., Droese D., Boeckh-Behrens T., Ringel F, & Meyer B. (2015). Changing the clinical course of glioma patients by preoperative motor mapping with navigated transcranial magnetic brain stimulation. BMC Cancer, 15, 231.
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3

Navigated Craniofacial Surgery Utilizing CT Data

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All pre- and postoperative imaging data were obtained (Brilliance CT: 1.0 mm slice thickness, Bright Speed 16, Philips, Netherlands), and then the data were transferred into the Brainlab iPlan CMF 3.0 software (Brainlab, Heimstetten, Germany). With the mirroring tool, the affected side was moved to the target area guided by the healthy side. The Brainlab Vector Vision 2 navigation system (Brainlab, Munich, Germany) was used to assist the operation in the experimental group. Brainlab iPlan CMF 3.0 software and Geomagic Studio 11 software were used to analyse the imaging data.
Zhang X., Ye L., Li H., Wang Y., Dilxat D., Liu W., Chen Y, & Liu L. (2018). Surgical navigation improves reductions accuracy of unilateral complicated zygomaticomaxillary complex fractures: a randomized controlled trial. Scientific Reports, 8, 6890.
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4

Targeted Biopsy Guidance for Glioma Resection

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For each patient, three-to-six regions of interest (ROIs) based on APTw
features and Gd-enhancement, and deemed feasible to access within the operative
field, were identified. The priority regions to sample included: (i) APTw
hyperintense, Gd enhancing; (ii) APTw hyperintense, Gd non-enhancing; and (iii)
APTw isointense, Gd enhancing. In patients without APTw hyperintensity or
Gd-enhancement, as clinically feasible and ethically appropriate, ROIs within
T2-weighted (T2w) and fluid-attenuated inversion
recovery (FLAIR) hyperintensities were sampled. Areas of large liquefactive
necrosis, hemorrhages, or large vessels evident on standard MRI sequences were
excluded from sampling [26 (link)]. All patients
were placed in a Mayfield three-point head fixation device, and intraoperative
surgical navigation (BrainLab VectorVision2, Heimstten, Germany) was applied to
locate the biopsy targets accurately. The neurosurgeons took all possible
precautions to minimize the error of sampling tissue when intraoperative biopsy
specimens were obtained at the time of surgery. For 13 of these patients, the
pre-determined ROIs were further labeled on the co-registered clinical MR images
in the BrainLab neuro-navigation system, and intraoperative screenshots were
completed to facilitate sample co-registration (Fig. 2).
Jiang S., Eberhart C.G., Zhang Y., Heo H.Y., Wen Z., Blair L., Qin H., Lim M., Quinones-Hinojosa A., Weingart J.D., Barker P.B., Pomper M.G., Laterra J., van Zijl P.C., Blakeley J.O, & Zhou J. (2017). Amide Proton Transfer-Weighted MR Image-Guided Stereotactic Biopsy in Patients with Newly Diagnosed Gliomas. European journal of cancer (Oxford, England : 1990), 83, 9-18.
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5

Precise MRI-Guided Brain Tumor Biopsy

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At pre-surgical planning, a neurosurgeon selected two-to-five ROIs, based on APTw and other acquired MR images. When possible, the pre-determined ROIs included both APTw hyperintense and iso-intense portions within Gd-enhancing regions. These ROIs, deemed feasible for sampling within the surgical field, were typically located in different slices. Areas of large liquefactive necrosis, hemorrhages, or large vessels evident on standard MRI sequences were excluded. At the time of surgery, patients were placed in a Mayfield three-point head fixation device, and the BrainLab neuro-navigation system (BrainLab VectorVision2, Heimstten, Germany) was used to label and locate the biopsy targets accurately. To minimize contributions from sampling error, specimens from ROIs were always obtained prior to resection. Each specimen was 1 mm in diameter × 7.5 mm in length, a size that is routinely achieved in stereotactic biopsies. For 14 patients, the exact de facto sites of sampling were further confirmed by a screenshot image in real time via the BrainLab system.
Jiang S., Eberhart C.G., Lim M., Heo H.Y., Zhang Y., Blair L., Wen Z., Holdhoff M., Lin D., Huang P., Qin H., Quinones-Hinojosa A., Weingart J.D., Barker P.B., Pomper M.G., Laterra J., van Zijl P.C., Blakeley J.O, & Zhou J. (2018). Identifying Recurrent Malignant Glioma after Treatment Using Amide Proton Transfer-Weighted MR Imaging: A Validation Study with Image-Guided Stereotactic Biopsy. Clinical cancer research : an official journal of the American Association for Cancer Research, 25(2), 552-561.
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