Anterior skull base meningiomas represent a wide cohort of tumors with different locations, extensions, configurations, and anatomical relationships. Diagnosis of these tumors and review of their therapies are inseparably connected with cranial imaging. We analyzed the influence of three-dimensional-virtual reality (3D-VR) reconstructions versus conventional computed tomography (CT) and magnetic resonance imaging (MRI) images (two-dimensional (2D) and screen 3D) on the identification of anatomical structures and on the surgical planning in patients with anterior skull base meningiomas. Medical files were retrospectively analyzed regarding patient- and disease-related data. Preoperative 2D-CT and 2D-MRI scans were retrospectively reconstructed to 3D-VR images and visualized via VR software to detect the characteristics of tumors. A questionnaire of experienced neurosurgeons evaluated the influence of the VR visualization technique on identification of tumor morphology and relevant anatomy and on surgical strategy. Thirty patients were included and 600 answer sheets were evaluated. The 3D-VR modality significantly influenced the detection of tumor-related anatomical structures (p = 0.002), recommended head positioning (p = 0.005), and surgical approach (p = 0.03). Therefore, the reconstruction of conventional preoperative 2D scans into 3D images and the spatial and anatomical presentation in VR models enabled greater understanding of anatomy and pathology, and thus influenced operation planning and strategy.

Anterior-communicating artery (ACoA) aneurysms have diverse configurations and anatomical variations. The evaluation and operative treatment of these aneurysms necessitates a perfect surgical strategy based on review of three-dimensional (3D) angioarchitecture using several radiologic imaging methods. We analyzed the influence of 3D virtual reality (VR) reconstructions versus conventional computed tomography angiography (CTA) scans on the identification of vascular anatomy and on surgical planning in patients with unruptured ACoA aneurysms. Medical files were retrospectively analyzed regarding patient- and disease-related data. Preoperative CTA scans were retrospectively reconstructed to 3D-VR images and visualized via VR software to detect the characteristics of unruptured ACoA aneurysms. A questionnaire was used to evaluate the influence of VR on the identification of aneurysm morphology and relevant arterial anatomy and on surgical strategy. Twenty-six patients were included and 520 answer sheets were evaluated. The 3D-VR modality significantly influenced detection of the aneurysm-related vascular structure (p = 0.0001), the recommended head positioning (p = 0.005), and the surgical approach (p = 0.001) in the planning of microsurgical clipping. Thus, reconstruction of conventional preoperative CTA scans into 3D images and the spatial presentation in VR models enabled greater understanding of the anatomy and pathology, provided realistic haptic feedback for aneurysm surgery, and influenced operation planning and strategy.

Das „Mobile Retter“ Modell-Projekt des Kreises Gütersloh intendiert mit der Smartphone-basierten, standortbezogenen Alarmierung von medizinisch qualifizierten Ersthelfern die inakzeptabel hohe Mortalität nach präklinischem Herz-Kreislauf-Stillstand zu senken. Das vorgestellte Projekt nutzt das große, bereits in der Bevölkerung vorhandene Potenzial von Ärzten, Rettungsdienstmitarbeitern, Feuerwehrkräften, Sanitätern sowie Gesundheits- und Krankenpflegepersonal (Mobile Retter) zur Einleitung qualifizierter Ersthelfermaßnahmen für Patienten in deren unmittelbarer Umgebung. Nach Notrufeingang in der Kreisleitstelle wird zeitgleich mit der Disponierung des Rettungsdienstes über einen zentralen Webserver-Dienst der nächstgelegene, verfügbare Mobile Retter standortbezogen über eine App auf seinem Smartphone alarmiert und mit den Einsatzdaten zum Einsatzort navigiert. Im ausgewerteten 20-monatigen Projektzeitraum konnte mit mittlerweile 477 Mobilen Rettern ein dichtes Ersthelfer-Netz, etwa 1,3 ‰ der Gesamtbevölkerung des Kreises Gütersloh entsprechend, aufgebaut werden. In 57 % der 522 durch die Rettungsleitstelle für die Stichworte „Bewusstlose Personen“ oder „Herz-Kreislauf-Stillstand“ ausgelösten Einsätze erfolgte eine Einsatzübernahme durch einen Mobilen Retter, bei 231 Einsätzen (78 % der Einsatzübernahmen) traf ein Mobiler Retter vor bzw. gleichzeitig mit dem Rettungsdienst ein. Das Mobile Retter-Projekt konnte im Kreis Gütersloh mit steigenden Mitglieder- und Einsatzzahlen erfolgreich implementiert werden und stellt somit ein neuartiges Versorgungskonzept dar, für das der Machbarkeitsnachweis erbracht werden konnte. „Mobile Rescuing“ depicts a pilot project in the German district of Gütersloh. A smartphone app is used for location-based alerting of medically qualified personnel intending to optimize survival after cardiac arrest. The project involves experienced knowledge of physicians, paramedics, nurses or firemen to promptly initiate resuscitation for patients in their immediate vicinity. For alerting keywords “cardiac arrest” or “unconsciousness” the dispatch center alarms the most proximate available “Mobile Rescuer” smartphone app, simultaneously with the rescue service via a central web service, navigating him to the emergency location. In the observed 20 month period 477 Mobile Rescuers, equating to 1.3 ‰ of the district population, have enrolled, forming a close-meshed net of experienced first-aiders. In 57 % of all 522 emergencies, Mobile Rescuers were found to take over the operation; in 231 cases (78 % of accepted operations) Mobile Rescuer arrived before the paramedics or simultaneously. The “Mobile Rescuing” project could successfully be implemented in the German district of Gütersloh as indicated by an increasing number of participating members and dispatched emergency operations. Providing the proof of principle, the smartphone-based alerting concept represents an innovative health care concept. ^* Das Projekt „Mobile Retter“ ist in einer bundesweiten Befragung zum Publikumssieger 2015 im Wettbewerb „Ausgezeichnete Orte im Land der Ideen“ gewählt worden. Informationen finden Sie unter http://www.welt.de/Advertorials/land-der-ideen-2015/article146435991/Mobile-Retter-App-ist-der-Publikumssieger-2015.html