title: Model-Updated Image-Guided Neurosurgery: Preliminary Analysis Using Intraoperative MR.
abstract: In this paper, initial clinical data from an intraoperative MR system are compared to calculations made by a three-dimensional finite element model of brain deformation. The preoperative and intraoperative MR data was collected on a patient undergoing a resection of an astrocytoma, grade 3 with non-enhancing and enhancing regions. The image volumes were co-registered and cortical displacements as well as subsurface structure movements were measured retrospectively. These data were then compared to model predictions undergoing intraoperative conditions of gravity and simulated tumor decompression. Computed results demonstrate that gravity and decompression effects account for approximately 40% and 30%, respectively, totaling a 70% recovery of shifting structures with the model. The results also suggest that a non-uniform decompressive stress distribution may be present during tumor resection. Based on this preliminary experience, model predictions constrained by intraoperative surface data appear to be a promising avenue for correcting brain shift during surgery. However, additional clinical cases where volumetric intraoperative MR data is available are needed to improve the understanding of tissue mechanics during resection.
authors: Dartmouth College, Thayer School of Engineering, HB8000, Hanover, NH 03755.
authors: Michael I
authors: MI
authors: Miga
authors: Dartmouth Hitchcock Medical Center, Lebanon, NH 03756.
authors: Andreas
authors: A
authors: Staubert
authors: University Hospital, Department of Neurological Surgery, Heidelberg School of Medicine, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
authors: Keith D
authors: KD
authors: Paulsen
authors: Francis E
authors: FE
authors: Kennedy
authors: Volker M
authors: VM
authors: Tronnier
authors: David W
authors: DW
authors: Roberts
authors: Alex
authors: A
authors: Hartov
authors: Leah A
authors: LA
authors: Platenik
authors: Karen E
authors: KE
authors: Lunn
keywords: finite element modeling and simulation; image guided therapy; intraoperative image registration techniques