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Biomedical subjects

R L Galloway

Publications and source records attributed to R L Galloway.

9 recordsLinked to original sources

Interactive image-guided neurosurgery.

Interactive image-guided (IIG) surgery involves the synchronal display of the tip of a surgical device on preoperative scans. This display allows the surgeon to locate the present surgical position relative to the final site of surgical interest. We have developed a technique for IIG surgery device based on a six-degree-of-freedom articulated arm. Design accuracy for the arm is less than 0.1 mm and the present implementation has a submillimetric accuracy. The display can show the surgical position on any tomographic image set with simultaneous display on up to three image sets. Laboratory results and clinical applications are discussed.

Brain

An independent application accuracy evaluation of stereotactic frame systems.

The purpose of incorporating stereotactic methodology into neurosurgical procedures is to consistently achieve a high degree of accuracy and precision in localizing intracranial targets. Therefore, the limits of resolution for the therapeutic intervention itself are a function of the accuracy and precision inherent to the particular stereotactic frame system itself. The total clinically relevant error (application accuracy) comprises errors associated with each procedural step, including imaging, target selection, vector calculation and the mechanical errors of stereotactic frames. To evaluate these parameters, a systematic error analysis was carried out in the 4 most commonly used CT-compatible stereotactic devices: the Brown-Roberts-Wells, Cosman-Roberts-Wells, Kelly-Goerss Compass (modified Todd-Wells) and Leksell frames. Over 7,681 independent test measurements were made. The results suggest a potentially significant degree of error in application accuracy of all stereotactic instrumentation which is accentuated by imaging-associated error. These individual error values must be considered with every clinical use of stereotactic frames.

Humans

A universal system for interactive image-directed neurosurgery.

Stereotactic methods confer great accuracy to intracranial target localization, but require strict adherence to a complex program of mechanical and computational maneuvers. A computerized, articulated, localizing 'arm' has been developed that frees the neurosurgeon of these constraints and provides a completely intuitive, 'user-friendly' interface. This universal system is independent of whatever localizing fiducial system is selected. The arm may be sterilized for intracranial use. A variety of intraoperative end effectors may be selected. The patient's CT/MR/PET scans are loaded into computer memory and a three-dimensional shaded surface wireframe diagram of the patient's head is displayed simultaneously with up to 3 independent sets of cross-referenced CT/MR/PET scan images on the intraoperative video screen. The arm's endpoint location and the directional vector are shown as cursors on the relevant scan slices, and change continuously as the surgeon moves the arm. Because the information is continuously updated, an unlimited number of targets and trajectories may be displayed throughout the operation. The arm has an ultimate design accuracy for end-point localization to within 0.1 mm throughout a target volume of 40 x 40 x 40 cm. The tested application accuracy of the first prototype model is 0.31 mm. In clinical use during 30 surgeries, its real-world application accuracy is 0.9 mm. This system provides stereotactic accuracy and universally compatible, intuitive, interactive operation.

Biopsy

Volumetric measurement of canine gliomas using MRI.

The evaluation of tumor size by neurodiagnostic imaging is an important tool in determining disease progression or treatment efficacy. Apparent tumor size on any single slice image is sensitive to tumor shape and slice orientation. Volumetric measurements which use multiple, stacked images attenuate that sensitivity and can provide insights into tumor architecture. Volumetric measurements were made of induced canine gliomas using three common MR imaging protocols and with and without a contrast agent. Comparisons of the volumes described by each technique are made.

Animals

Stereotactic neurosurgery.

Stereotactic neurosurgery is the technique for locating targets of surgical interest within the brain relative to an external frame of reference. Traditionally, that has meant temporarily attaching a mechanical frame to the patient's skull or scalp. Recent techniques are moving toward ways of reducing the trauma to the patient while retaining the information provided by the frame. Historically, the predominant use of the frames was for placement of electrodes. The advent of computed tomography led to a rebirth of stereotaxy for biopsy and as a guide for resection. Recent advances in computing are supplementing these techniques to allow improved surgical planning and intraoperative information. Finally, highly directed radiation therapy or stereotactic radiosurgery is discussed.

Brain

The optical measurement of 1,2-propanediol for the determination of lung capillary permeability surface area.

A technique has been developed which allows for the optical measurement of the concentration-time relationship for a diffusion-limited material in indicator dilution studies. The material, 1-2 propanediol, is used as a probe of the permeability of capillaries in the lung. Comparisons between standard radioisotope measurements and the optical measurements are provided and show excellent agreement. The optical method represents an improvement over the standard radioisotope method in that it provides the same data at lower cost, lower risk, and without the delay required by the radiographic methods.

Animals

Magnetic resonance and computed tomographic image-directed stereotaxy for animal research.

Current stereotactic frames for animal experimentation presume normal intracranial anatomy for atlas-directed probe placement. This is an invalid assumption for animal brain tumor models, where distortions of cerebral anatomy make image-directed stereotaxy necessary. To address this need, an accurate and reproducible magnetic resonance and computed tomographic compatible image-directed stereotactic apparatus for animal experimentation is presented.

Animals

Growth factors in the tumorigenicity of a brain tumor cell line.

We studied a virally induced canine gliosarcoma brain tumor cell line capable of producing brain tumors in vivo following intracerebral inoculation of the cells into the brains of adult mongrel dogs. Cloned populations from this cell line differed in their ability to produce brain tumors in vivo. In vitro transforming growth factor-beta secretion by each clone correlated with in vivo tumorigenicity. Mitogenic activity like that produced with platelet-derived growth factor was also secreted by each clone and correlated with in vivo tumorigenicity. Epidermal growth factor and transforming growth factor-alpha production was not detected in any of the clones of canine gliosarcoma cells. Although only some of the brain tumor cell clones were able to produce tumors in immunologically normal dogs, brain tumors were produced in all dogs pretreated with cyclosporin and in all "nude" mice, suggesting that tumor immunology plays an important role in this brain tumor model. In vitro cloning efficiency of each brain tumor cell clone also correlated with in vivo tumorigenicity. We postulate that transforming growth factor-beta may both stimulate brain tumor cell growth and inhibit host antitumor immune surveillance.

Animals