title: A comparative analysis of coregistered ultrasound and magnetic resonance imaging in neurosurgery.
abstract: OBJECTIVE
  This work presents qualitative and quantitative side-by-side comparisons of oblique coregistered magnetic resonance imaging (MRI) scans and ultrasound images obtained during 35 neurosurgical procedures.
  
  
  METHODS
  Spatially registered series of ultrasound images were recorded for subsequent off-line evaluation and comparison with corresponding preoperative MRI studies. The degree of misalignment was reduced by reregistering the target volume directly with segmented features.
  
  
  RESULTS
  The initial apparent spatial misalignment of the target volume after craniotomy ranged from 0.11 to 8.73 mm (mean, 4.01 mm). After reregistration, the mutual information in overlapping segmented features was increased, presumably evidence of a better alignment locally. Additionally, the degree of feature congruence, which was assessed quantitatively through a convex hull approximation, demonstrated that the ultrasound volume was consistently smaller than its MRI counterpart.
  
  
  CONCLUSIONS
  Although intraoperative ultrasound tends to be difficult to interpret by itself, when accurately coregistered with preoperative MRI scans, its potential utility as a navigational guide is enhanced.
authors.affiliation: Thayer School of Engineering, Dartmouth College, HB 8000, Hanover, NH 03755, USA. Alex.Hartov@Dartmouth.edu
authors.forename: Alex
authors.initials: A
authors.lastname: Hartov
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.forename: Keith D
authors.initials: KD
authors.lastname: Paulsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D013382:Subtraction Technique; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome