Intraoperatively updated neuroimaging using brain modeling and sparse data.
OBJECTIVE
Image-guided neurosurgery incorporating preoperatively obtained imaging information is subject to spatial error resulting from intraoperative brain displacement and deformation. A strategy to update preoperative imaging using readily available intraoperative information has been developed and implemented.


METHODS
Preoperative magnetic resonance imaging is used to generate a patient-specific three-dimensional finite element model of the brain by which deformation resulting from multiple surgical processes may be simulated. Sparse imaging data obtained subsequently, such as from digital cameras or ultrasound, are then used to prescribe the displacement of selected points within the model. Based on the model, interpolation to the resolution of preoperative imaging may then be performed.


RESULTS
The algorithms for generation of the finite element model and for its subsequent deformation were successfully validated using a pig brain model. In these experiments, the method recovered 84% of the intraoperative shift resulting from surgically induced tissue motion. Preliminary clinical application in the operating room has demonstrated feasibility.


CONCLUSIONS
A strategy by which intraoperative brain deformation may be accounted for has been developed, validated in an animal model, and demonstrated clinically.
Roberts
D W
DW
Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
Miga
M I
MI
Hartov
A
A
Eisner
S
S
Lemery
J M
JM
Kennedy
F E
FE
Paulsen
K D
KD
D000328:Adult; D001927:Brain Diseases / Q000601:surgery; D001931:Brain Mapping / Q000295:instrumentation*; D003198:Computer Simulation; D003952:Diagnostic Imaging / Q000295:instrumentation*; D004827:Epilepsy / Q000601:surgery; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D008297:Male; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D013238:Stereotaxic Techniques / Q000295:instrumentation*