ARRS 2022 Abstracts

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E1053. Photorealistic Depiction of Intracranial Tumors Using Cinematic Rendering: A Pictorial Review with Implications for Pre-Surgical Planning
Authors
  1. Dhairya Lakhani; West Virginia University
  2. Abdul-Rahman Al-Hallak; West Virginia University
  3. Abdul Tarabishy; West Virginia University
  4. Gerard Deib; West Virginia University
Objective:
Cinematic rendering (CR) incorporates a complex lightening model that allows for the creation of photorealistic models from the reconstruction of isotropic 3D imaging data, by utilizing a complex algorithm. The purpose of this study was to assess implications of cinematic rendering in neuroimaging with focus on intracranial tumors and pre-surgical planning utilizing MRI data. Although the CR algorithm has mostly been used to depict CT data, its use in depicting the brain utilizing MRI data is not well documented in the literature.

Materials and Methods:
We present 3D reconstructed images on series of cases with intracranial tumor. Isotropic, high-resolution volumetric T1 MPRAGE 3T MRI images on all patients with intracranial tumor were collected. 3D cinematic rendering was performed utilizing Anatomy Education (Siemens, Munich, Germany). The goal was to enable a comprehensive understanding of relationship of brain tumor with an individual patient’s cortical surface anatomy, dural-based structures, and scalp landmarks for optimal pre-surgical planning.

Results:
In a series of cases with intracranial tumors, we observed that users can accentuate the appearance of structures by changing the display settings on the CR reconstructions utilizing MRI data. Consequently, visualization of cortex to white matter, brain surface to vessels, subarachnoid space to cortex and skull to intracranial structures can be optimized. Layers of the overlying soft tissue can be progressively removed to provide a comprehensive assessment of the entire ROI . CR models can be enlarged, rotated, and shifted arbitrarily. In the context of the brain surface, there are several benefits to utilizing this technology. Complex, small structures can be demonstrated in very high detail. The depth and architecture of the sulci can be better appreciated than on traditional imaging modalities. With appropriate display settings, the relationship of the cortical surface to the adjacent vasculature can also be delineated.

Conclusion:
Understanding and conceptualizing the anatomic location of the brain tumor in a format that depicts the relative proximity of adjacent structures in all dimensions and degrees of freedom aid in presurgical planning. Further, the technology that improves visualization of these complex anatomic structures and their spatial relationship would significantly improve trainee and physician knowledge and consequently patient outcomes.