title: IBIS: an OR ready open-source platform for image-guided neurosurgery.
abstract: OBJECTIVE
  Navigation systems commonly used in neurosurgery suffer from two main drawbacks: (1) their accuracy degrades over the course of the operation and (2) they require the surgeon to mentally map images from the monitor to the patient. In this paper, we introduce the Intraoperative Brain Imaging System (IBIS), an open-source image-guided neurosurgery research platform that implements a novel workflow where navigation accuracy is improved using tracked intraoperative ultrasound (iUS) and the visualization of navigation information is facilitated through the use of augmented reality (AR).
  
  
  METHODS
  The IBIS platform allows a surgeon to capture tracked iUS images and use them to automatically update preoperative patient models and plans through fast GPU-based reconstruction and registration methods. Navigation, resection and iUS-based brain shift correction can all be performed using an AR view. IBIS has an intuitive graphical user interface for the calibration of a US probe, a surgical pointer as well as video devices used for AR (e.g., a surgical microscope).
  
  
  RESULTS
  The components of IBIS have been validated in the laboratory and evaluated in the operating room. Image-to-patient registration accuracy is on the order of [Formula: see text] and can be improved with iUS to a median target registration error of 2.54 mm. The accuracy of the US probe calibration is between 0.49 and 0.82 mm. The average reprojection error of the AR system is [Formula: see text]. The system has been used in the operating room for various types of surgery, including brain tumor resection, vascular neurosurgery, spine surgery and DBS electrode implantation.
  
  
  CONCLUSIONS
  The IBIS platform is a validated system that allows researchers to quickly bring the results of their work into the operating room for evaluation. It is the first open-source navigation system to provide a complete solution for AR visualization.
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada. simon.drouin@mail.mcgill.ca.
authors: Simon
authors: http://orcid.org/0000-0002-7265-8747
authors: S
authors: Drouin
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Anna
authors: A
authors: Kochanowska
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Marta
authors: M
authors: Kersten-Oertel
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Ian J
authors: IJ
authors: Gerard
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Rina
authors: R
authors: Zelmann
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Dante
authors: D
authors: De Nigris
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Silvain
authors: S
authors: Bériault
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Tal
authors: T
authors: Arbel
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Denis
authors: D
authors: Sirhan
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Abbas F
authors: AF
authors: Sadikot
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Jeffery A
authors: JA
authors: Hall
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: David S
authors: DS
authors: Sinclair
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Kevin
authors: K
authors: Petrecca
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: Rolando F
authors: RF
authors: DelMaestro
authors: McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB 221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
authors: D Louis
authors: DL
authors: Collins
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D046690:Deep Brain Stimulation; D006801:Humans; D008866:Microsurgery; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D009873:Operating Rooms; D019919:Prosthesis Implantation; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014463:Ultrasonography; D014584:User-Computer Interface; D014656:Vascular Surgical Procedures / Q000379:methods; D057188:Workflow
keywords: Augmented reality; Brain shift correction; Image-guided surgery; Ultrasound