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Biomedical subjects

Richard D Bucholz

Publications and source records attributed to Richard D Bucholz.

4 recordsLinked to original sources

The next generation of navigational technology.

Registration for image guidance has become significantly simplified and will continue to improve in accuracy. Unparalleled visualization of target tissues has been made possible through advances in imaging technologies,some of which have been modified to be employed directly in the operating room. With the advent of functional imaging techniques, the promise of functional rather than structural imaging suggests potentially fascinating interventions based on functional disturbances in tissue. Given the aggressive nature of the technology industry, some of the issues in surgical navigation discussed in this article have probably already been resolved and may be on their way to market. Undoubtedly, other points will also soon be addressed in novel and imaginative ways. As a result, the authors hope, the practice of rhinology will continue to evolve to improve the standard of care for patients. The future of many therapeutic interventions seems to be tied to the information infrastructure provided by information-guided therapy. Only through the innovative use of information-guided technology will further minimization of risks and maximization of benefit be achieved.

Endoscopy↗

MRI-based high-dimensional hippocampal mapping in mesial temporal lobe epilepsy.

MRI-based evaluation of the hippocampus is important in the assessment and treatment of patients with mesial temporal lobe epilepsy (MTLE). Using MRI-based large-deformation high-dimensional mapping (HDM-LD), which allows structural evaluation of regions of the hippocampus, we document the HDM-LD-defined pattern of hippocampal deformation in MTLE patients compared with matched controls. In 30 subjects with MTLE and confirmed medial temporal lobe sclerosis (MTS), we performed measurements of intracranial area, brain parenchymal volume and deformation-based hippocampal segmentations, and then grouped patients into right and left MTS groups (resulting in 15 subjects in each group). Using HDM-LD techniques, we compared the right and left MTS groups with a group of 15 matched controls. Analysis included both the MTS and contralateral hippocampi, and covariance for changes in brain parenchymal volume. Final results were interpreted using a segmentation showing normal hippocampal surface subfield anatomy. Comparing the MTS groups with controls, after covarying with brain parenchymal volume, the MTS hippocampi showed significant volume loss (P < 0.0001), contralateral hippocampi showed no significant volume loss. HDM-LD techniques showed significant shape changes, with marked inward deviation in the Sommer sector of the MTS hippocampi. In the contralateral hippocampi, the inferior surface of the hippocampal body showed inward deformation in the medial aspect of the subiculum, with minimal involvement of the Sommer sector. HDM-LD shows involvement of subregions of the hippocampus which are consistent with MTS histopathology. Contralateral hippocampi show different HDM-LD changes, suggesting that the underlying disease process in the contralateral hippocampi is different from MTS.

Adult↗

Hippocampal deformation-based shape analysis in epilepsy and unilateral mesial temporal sclerosis.

PURPOSE: To assess shape changes in patients with mesial temporal sclerosis (MTS) and temporal lobe epilepsy (TLE), by using deformation-based hippocampal shape analysis. METHODS: We retrospectively reviewed magnetic resonance imaging (MRI) studies in 30 subjects with unilateral MTS (15 right-sided MTS, 15 left-sided MTS) and TLE. We defined the "average" hippocampus in the right- and left-MTS groups by generating a mean transformation for the 15 deformation images in each group. Further to quantify the difference between the hippocampi, we coregistered the mean transformation of the involved hippocampus (with MTS) to the contralateral hippocampus, considering the left- and right-MTS groups independently. We generated a color "flame" scale showing degrees of outward and inward deviation of the coregistered hippocampi. RESULTS: Both the right- and left-MTS groups showed similar shape changes, with maximal inward deformation in the medial and lateral hippocampal head and the hippocampal tail. However, more extensive involvement was seen in the lateral hippocampal body in the right-MTS group as compared with the left. CONCLUSIONS: Deformation-based hippocampal shape analysis shows specific regions of hippocampal surface anatomy that are most affected in MTS. This technique may aid in detection of clinically significant anatomic abnormalities of the hippocampus in patients with epilepsy.

Adolescent↗