title: Coregistered intraoperative ultrasonography in resection of malignant glioma.
abstract: OBJECTIVE
  The authors present their experience with coregistration of preoperative imaging data to intraoperative ultrasonography in the resection of high-grade gliomas, focusing on methodology and clinical observation.
  
  
  METHODS
  Images were obtained preoperatively and coregistered to intraoperative hand-held ultrasound images by merging the respective imaging coordinate systems. After patient registration and imaging calibration, the authors computed the location on the magnetic resonance (MR) space of each pixel on an ultrasound image acquired in the operating room. The data were retrospectively reviewed in 11 patients with high-grade gliomas who underwent ultrasonography-assisted resection at our institution between June 2000 and December 2002. Satisfactory coregistration of intraoperative ultrasound and preoperative MR images was accomplished in all cases. Ultrasound and MR image data were closely congruent. Preoperative setup and intraoperative use of the system were unencumbering.
  
  
  CONCLUSIONS
  Based on these preliminary results, intraoperative ultrasonography is an attractive neuronavigational alternative, by which a less expensive and constraining imaging technique is used to acquire updated information. Optimal intraoperative guidance can be provided by the integration of this with other imaging studies.
authors.affiliation: Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. dnikas@Hitchcock.org
authors.forename: Dimitrios C
authors.initials: DC
authors.lastname: Nikas
authors.forename: Alexander
authors.initials: A
authors.lastname: Hartov
authors.forename: Karen
authors.initials: K
authors.lastname: Lunn
authors.forename: Kyle
authors.initials: K
authors.lastname: Rick
authors.forename: Keith
authors.initials: K
authors.lastname: Paulsen
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000368:Aged; D002138:Calibration; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation; D011300:Preoperative Care; D015173:Supratentorial Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods*