Image Fusion: A Novel Approach in Gamma Knife Surgery Treating Trigeminal Neuralgia.

Objective: Finding accurate locations for radiosurgical targets in trigeminal neuralgia (TN) remains challenging. This study provides a novel approach of image fusion used in locating radiosurgical targets for gamma knife surgery (GKS) in the treatment of TN. Methods: Magnetic resonance imaging (MRI) scans were performed before frame fixation, and computed tomography (CT) scans were performed following frame fixation. Fusion of the CT and MRI images was performed to locate the treatment target. The therapeutic effects were evaluated following GKS. Results: The CT image ensures precise imaging for defining the fiducial localizers. Multi-modality medical imaging allows the trigeminal nerve (CNV) to be distinguished from the adjacent corresponding vessels. Thus, image fusion makes isocenter positioning more accurate. Significant changes in the frequency, intensity, and length of pain attacks following GKS were achieved. Conclusion: Diagnostic MRI co-registered with stereotactic CT can be used for accurate target location. The therapeutic effects of image fusion for GKS treatment of TN are satisfactory.