title: Surgical navigation in the open MRI.
abstract: The introduction of MRI into neurosurgery has opened multiple avenues, but also introduced new challenges. The open-configuration intraoperative MRI installed at the Brigham and Women's Hospital in 1996 has been used for more than 500 open craniotomies and beyond 100 biopsies. Furthermore the versatile applicability, employing the same principles, is evident by its frequent use in other areas of the body. However, while intraoperative scanning in the SignaSP yielded unprecedented imaging during neurosurgical procedures their usage for navigation proved bulky and unhandy. To be fully integrated into the procedure, acquisition and display of intraoperative data have to be dynamic and primarily driven by the surgeon performing the procedure. To use the benefits of computer-assisted navigation systems together with immediate availability of intraoperative imaging we developed a software package. This "3D Slicer" has been used routinely for biopsies and open craniotomies. The system is stable and reliable. Pre- and intraoperative data can be visualized to plan and perform surgery, as well as to accommodate for intraoperative deformations, "brain shift", by providing online data acquisition.
authors.affiliation: Department of Neurosurgery, University Kiel, Kiel, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Nabavi
authors.forename: D T
authors.initials: DT
authors.lastname: Gering
authors.forename: D F
authors.initials: DF
authors.lastname: Kacher
authors.forename: I F
authors.initials: IF
authors.lastname: Talos
authors.forename: W M
authors.initials: WM
authors.lastname: Wells
authors.forename: R
authors.initials: R
authors.lastname: Kikinis
authors.forename: P McL
authors.initials: PM
authors.lastname: Black
authors.forename: F A
authors.initials: FA
authors.lastname: Jolesz
mesh_terms: D016477:Artifacts; D001706:Biopsy / Q000295:instrumentation; D001921:Brain / Q000473:pathology / Q000601:surgery; D001927:Brain Diseases / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy / Q000295:instrumentation; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D021621:Imaging, Three-Dimensional / Q000295:instrumentation; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D038361:Neuronavigation / Q000295:instrumentation*; D012680:Sensitivity and Specificity