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Imagerie fonctionnelle peropératoire naviguée pour l'optimisation de la chirurgie des tumeurs cérébrales

Abstract : Gliomas are primitive brain tumors, which represent the second most frequent cancer among children and the third cause of death among young adult. It has been shown that resection surgery improves patient outcomes, leading to its cure for some cases. Intraoperative detection of residual tumor allows the surgeon to check the quality of its resection gesture. A new intraoperative imaging modality has been proposed as a solution to detect residual tumors. It relies on a nuclear probe associated with an optical localization system. This new modality, called positron surface imaging (PSI), generates images of the activity surface distribution of a 18 F based radiotracer of a scanned area of interest. Not used in clinical context yet, we proposed for the first time a feasibility study of its usage to optimize brain tumor surgery. We show limitations of the potential usage of PSI in neurosurgery through experimental studies, considering intraoperatives factors which may influence quality of generated images. Contributions in this study are presented on three axes. First, we want to generate PSI functional images with a low computational time. Acquisition models applied to measurements improve image quality at the cost of high computational time. We suggest a new acquisition model dedicated to intraoperative usage, allowing enhancement of spatial resolution and contrast of images for a low computational time. The second axis is dedicated to the study of the intraoperative acquisition impact on system performance. We propose to estimate the intrinsic parameters of nuclear probe and the study of scanning process on their values. Finally, we present the validation of acquisition models dedicated to intraoperative context. We show a comparative study of acquisition models performance considering potential impact of scanning speed process during acquisition. This work has contributed to the feasibility study of using an ISP system in the intraoperative context, proposed for the first time in neurosurgery.
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Frédéric Monge. Imagerie fonctionnelle peropératoire naviguée pour l'optimisation de la chirurgie des tumeurs cérébrales. Traitement du signal et de l'image [eess.SP]. Université Rennes 1, 2016. Français. ⟨NNT : 2016REN1B013⟩. ⟨tel-01485170⟩

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