Implementing functional preoperative mapping in the clinical routine of a neurosurgical department: Technical Note.

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Implementing functional preoperative mapping in the clinical routine of a neurosurgical department: Technical Note.

World Neurosurg. 2017 Apr 01;:

Authors: Sollmann N, Meyer B, Krieg SM

Abstract
BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is increasingly being used for mapping of various brain functions and nTMS-based tractography in neurosurgical departments worldwide. When a department starts integrating nTMS data into the clinical workflow, smooth implementation in the existing hospital's infrastructure is mandatory. However, standardized approaches beyond the mapping or tractography procedures themselves have not yet been described.
METHODS: To create an effective workflow for neurosurgical nTMS mapping, we present the results of our 7 years of experience and progressive integration into clinical routine.
RESULTS: After indication for mapping is made, the workflow starts with patient admission and includes all preoperative steps until tumor resection. Importantly, only standard software and devices were used, thus enabling new centers to easily integrate data derived from nTMS mapping and nTMS-based tractography into their hospital's infrastructure. Registration of the patient, appointment planning and documentation of results of the nTMS procedures within the hospital information system (HIS) can be achieved by a newly presented, tailored software mask. As another important part of the workflow, nTMS data is imported into the picture archiving and communication system (PACS) via PACS integrator software. Additionally, for surgical planning including nTMS-based tractography, nTMS data can be effectively included in surgical neuronavigation software.
CONCLUSIONS: Optimized integration of nTMS data can be achieved using a standardized workflow. The seamless integration and availability of nTMS data are crucial aspects required for acceptance in the clinical routine. This workflow can serve as a guide for centers starting to use nTMS data in their patients.

PMID: 28377253 [PubMed - as supplied by publisher]

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