Choroid plexus papilloma originating from the cerebrum parenchyma.

BACKGROUND: Choroid plexus papilloma (CPP) can develop at a primary intraparenchymal location completely unrelated to the ventricular system. Here, we present a case of CPP that was difficult to diagnose preoperatively. CASE DESCRIPTION: Preoperative imaging and operative findings showed that the tumor originated entirely within the cerebrum parenchyma, with no connections between the tumor and the ventricular system. Histopathological examination of the tumor revealed a papillary structure with a single layer of well-differentiated columnar epithelium in the lesion. Furthermore, part of this lesion had infiltrated the cerebral parenchyma. Therefore, the tumor was diagnosed as CPP, and the diagnosis was confirmed by immunohistological examination. CONCLUSIONS: CPP originating as intraparenchymal growths are extremely rare. Origins of extraventricular CCP are discussed in the context of the literature.

Newly developed electromagnetic tracked flexible neuroendoscope.

Flexible endoscopes can be used in areas that are difficult to approach using rigid endoscopes. No current real-time navigation systems identify the tip of the flexible neuroendoscope. We have developed a flexible neuroendoscope mounted with a magnetic field sensor tip position-tracking system and evaluated the accuracy of this magnetic field neuronavigation system. Based on an existing flexible neuroendoscope, we created a prototype with a built-in magnetic field sensor in the tip. A magnetic field measurement device provides a magnetic field with a working volume of 500 × 500 × 500 mm in front of the device. The device consists of a flat field generator that creates a pulsed magnetic field, connected to a system control unit that interfaces with a computer. The magnetic field sensor (1.8 × 9 mm) was sealed in a site 0.9 mm from the endoscope tip. Accuracy of neuroendoscope tracking was measured using a three-dimensional coordinate-measuring machine that measures the position of objects along 3 axes, with an error of about 3 µm. The accuracy for this neuroendoscope with built-in magnetic field sensor was root mean square error of 1.2 mm and standard deviation of 0.5 mm. This magnetic field neuronavigation system enables real-time tracking of the tip of the flexible neuroendoscope. Application of this flexible neuroendoscope to intraoperative navigation appears promising, and may provide new advantages for minimally invasive endoscopic surgery.

Multimodality imaging suite: neo-futuristic diagnostic imaging operating suite marks a significant milestone for innovation in medical technology.

In February 2006, Tokai University Hospital officially opened the imaging operation suite, which is the first hybrid neurosurgical procedure suite to combine magnetic resonance imaging, computed tomography and angiography with a neurosurgical operating room. Here, we describe the concept of the imaging operation suite and the first 4 years' experience using this suite.

Improving patient safety in the intra-operative MRI suite using an on-duty safety nurse, safety manual and checklist.

This paper describes the use of an on-duty safety nurse, a surgical safety manual and a checklist as an essential precursor to evaluating how these approaches affect surgical quality, communication in surgery crews and contribute to the safety of surgical care in the intra-operative magnetic resonance imaging (MRI) suite.

Fully functional MR-compatible flexible operating table resolves the neurosurgeon's dilemma over use of intraoperative MRI.

In February 2006, our hospital officially opened the Magnetic Resonance / X-ray / operation (MRXO) suite, which is the first hybrid neurosurgical procedure suite to combine magnetic resonance imaging (MRI), computed tomography and angiography with a neurosurgical operating room. For this suite, we have developed a specially designed fully functional magnetic resonance (MR)-compatible flexible operating table. Here, we describe the details of this operating table and discuss its advantages. Its MR-compatible tabletop can be bent during surgery. The specially designed MR-compatible flexible operating table for the MRXO suite reduces limitations on neurosurgeons during standard neurosurgical procedures. Also, it does not give rise to imaging artifacts on MRI. The specially designed MR-compatible flexible operating table resolves the neurosurgeon's dilemma over use of intraoperative MRI.

World's first magnetic resonance imaging/x-ray/operating room suite: a significant milestone in the improvement of neurosurgical diagnosis and treatment.

OBJECT: In February 2006, the magnetic resonance/x-ray/operating room (MRXO) suite opened at the authors' institution. This is the first hybrid neurosurgical procedure suite to combine magnetic resonance (MR) imaging, computed tomography (CT), and angiography within a neurosurgical operating room (OR). In the present paper the authors describe the concept of the MRXO as well as their first 10 months of experience using this suite, and discuss its advantages and limitations. METHODS: In the MRXO suite, the combined OR and angiography (OR-angiography) station is located in the middle of the suite, and the MR imaging and CT scanning stations are each installed in an adjoining bay connected to the OR-angiography station by shielded sliding doors. The surgical, MR imaging, angiography, and CT tables are positioned in order of use. The patient lies on a fully MR imaging- and radiography-compatible mobile patient tabletop that is used to move the patient quickly and safely among the tables in the imaging and operating components of the MRXO suite. RESULTS: The authors performed all interventional procedures safely. The specially designed operating tabletop of the MRXO suite reduced the limitations on neurosurgeons during standard neurosurgical procedures. This hybrid suite helps to provide high-quality intraoperative imaging, greatly reducing the risk of unexpected events during the procedure. CONCLUSIONS: The MRXO suite, which combines OR and imaging equipment, represents a significant milestone in the improvement of neurosurgical diagnosis and treatment and other interventional procedures. Another advantage of the MRXO suite is its cost-effectiveness, which is partly due to its streamlined imaging procedure.