title: Accurate localization of optic radiation during neurosurgery in an interventional MRI suite.
abstract: Accurate localization of the optic radiation is key to improving the surgical outcome for patients undergoing anterior temporal lobe resection for the treatment of refractory focal epilepsy. Current commercial interventional magnetic resonance imaging (MRI) scanners are capable of performing anatomical and diffusion weighted imaging and are used for guidance during various neurosurgical procedures. We present an interventional imaging workflow that can accurately localize the optic radiation during surgery. The workflow is driven by a near real-time multichannel nonrigid image registration algorithm that uses both anatomical and fractional anisotropy pre- and intra-operative images. The proposed workflow is implemented on graphical processing units and we perform a warping of the pre-operatively parcellated optic radiation to the intra-operative space in under 3 min making the proposed algorithm suitable for use under the stringent time constraints of neurosurgical procedures. The method was validated using both a numerical phantom and clinical data using pre- and post-operative images from patients who had undergone surgery for treatment of refractory focal epilepsy and shows strong correlation between the observed post-operative visual field deficit and the predicted damage to the optic radiation. We also validate the algorithm using interventional MRI datasets from a small cohort of patients. This work could be of significant utility in image guided interventions and facilitate effective surgical treatments.
authors.affiliation: Department of Computer Science, University College London, UK. p.daga@cs.ucl.ac.uk
authors.forename: Pankaj
authors.initials: P
authors.lastname: Daga
authors.forename: Gavin
authors.initials: G
authors.lastname: Winston
authors.forename: Marc
authors.initials: M
authors.lastname: Modat
authors.forename: Mark
authors.initials: M
authors.lastname: White
authors.forename: Laura
authors.initials: L
authors.lastname: Mancini
authors.forename: M Jorge
authors.initials: MJ
authors.lastname: Cardoso
authors.forename: Mark
authors.initials: M
authors.lastname: Symms
authors.forename: Jason
authors.initials: J
authors.lastname: Stretton
authors.forename: Andrew W
authors.initials: AW
authors.lastname: McEvoy
authors.forename: John
authors.initials: J
authors.lastname: Thornton
authors.forename: Caroline
authors.initials: C
authors.lastname: Micallef
authors.forename: Tarek
authors.initials: T
authors.lastname: Yousry
authors.forename: David J
authors.initials: DJ
authors.lastname: Hawkes
authors.forename: John S
authors.initials: JS
authors.lastname: Duncan
authors.forename: Sebastien
authors.initials: S
authors.lastname: Ourselin
mesh_terms: D000465:Algorithms; D004827:Epilepsy / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D020221:Optic Nerve Injuries / Q000517:prevention & control*; D019047:Phantoms, Imaging; D011832:Radiation Injuries / Q000517:prevention & control*; D011834:Radiation Monitoring / Q000379:methods*; D015203:Reproducibility of Results