Planning and Simulation of Neurosurgery in a Virtual Reality Environment

Kockro, Ralf A.; Serra, Luis; Tseng-Tsai, Yeo; Chan, Colin; Yih-Yian, Sitoh; Gim-Guan, Chua; Lee, Eugene; Hoe, Lee Yen; Ng, Henry; Nowinski, Wiesław L.

doi:10.1093/neurosurgery/46.1.118

Cited by 164 publications

(96 citation statements)

References 37 publications

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“…Three-dimensional virtual reality models of a patient allowed quick and easy understanding of complex intracranial lesions. 7,11 In cavernoma surgery a 3D virtual reality model enables the surgeon to preoperatively visualize the cortical surface with its gyral and sulcal patterns including the cortical vessels. A very precise image of what the surgeon will see after the craniotomy is created by the additional display of the skull and the skin.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual reality planning using magnetic resonance angiography

Fischer

Stadie

Schwandt

et al. 2009

FOC

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Object The aim of the authors in this study was to introduce a minimally invasive superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery by the preselection of appropriate donor and recipient branches in a 3D virtual reality setting based on 3-T MR angiography data. Methods An STA-MCA anastomosis was performed in each of 5 patients. Before surgery, 3-T MR imaging was performed with 3D magnetization-prepared rapid acquisition gradient echo sequences, and a high-resolution CT 3D dataset was obtained. Image fusion and the construction of a 3D virtual reality model of each patient were completed. Results In the 3D virtual reality setting, the skin surface, skull surface, and extra- and intracranial arteries as well as the cortical brain surface could be displayed in detail. The surgical approach was successfully visualized in virtual reality. The anatomical relationship of structures of interest could be evaluated based on different values of translucency in all cases. The closest point of the appropriate donor branch of the STA and the most suitable recipient M3 or M4 segment could be calculated with high accuracy preoperatively and determined as the center point of the following minicraniotomy. Localization of the craniotomy and the skin incision on top of the STA branch was calculated with the system, and these data were transferred onto the patient's skin before surgery. In all cases the preselected arteries could be found intraoperatively in exact agreement with the preoperative planning data. Successful extracranial-intracranial bypass surgery was achieved without stereotactic neuronavigation via a preselected minimally invasive approach in all cases. Subsequent enlargement of the craniotomy was not necessary. Perioperative complications were not observed. All bypasses remained patent on follow-up. Conclusions With the application of a 3D virtual reality planning system, the extent of skin incision and tissue trauma as well as the size of the bone flap was minimal. The closest point of the appropriate donor branch of the STA and the most suitable recipient M3 or M4 segment could be preoperatively determined with high accuracy so that the STA-MCA bypass could be safely and effectively performed through an optimally located minicraniotomy with a mean diameter of 22 mm without the need for stereotactic guidance.

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Section: Discussionmentioning

confidence: 99%

Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual reality planning using magnetic resonance angiography

Fischer

Stadie

Schwandt

et al. 2009

FOC

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“…DiGioia et al developed a volumetric image overlay system by projecting three-dimensional virtual image on a semitransparent mirror in which the physician simultaneously can observe the actual patient and computer-generated images [2], [4]. A similar device using this concept is commercially available under the brand name of Dexteroscope [7], which also involves elaborate preoperative calibration and requires realtime spatial tracking of all components, including the patient, physician's head, overlay display, mirror, and surgical tools. Grimson et al graphically overlaid segmented 3D preoperative images onto video images of the patient [5].…”

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confidence: 99%

Image Overlay Guidance for Needle Insertion in CT Scanner

Fichtinger

Deguet

Masamune

et al. 2005

IEEE Trans. Biomed. Eng.

104

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Abstract-We present an image overlay system to aid needle insertion procedures in CT scanners. The device consists of a display and a semitransparent mirror that is mounted on the gantry. Looking at the patient through the mirror, the CT image appears to be floating inside the patient with correct size and position, thereby providing the physician with two-dimensional "X-ray vision" to guide needle insertions. The physician inserts the needle following the optimal path identified in the CT image rendered on the display and thus reflected in the mirror. The system promises to reduce X-ray dose, patient discomfort, and procedure time by significantly reducing faulty insertion attempts. It may also increase needle placement accuracy. We report the design and implementation of the image overlay system followed by the results of phantom and cadaver experiments in several clinical applications.

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“…Vários trabalhos verificados na literatura utilizaram a estereoscopia com múltiplos propósitos: de ensino 1-8 ; treinamento [9][10][11][12][13][14][15] ; planejamento operatório [16][17][18][19][20][21] ; tratamento [22][23][24][25][26][27] e documentação. [28][29][30] Considerou-se, neste trabalho, a estereoscopia como componente essencial dos ambientes de realidade virtual (RV).…”

Section: Início E Evolução Do Conhecimento Da Neuroanatomia E Utilizaunclassified

“…11,12,39,40 A RV também já é citada como uma ferramenta no processo de planejamento operatório. 13,[16][17][18][19][20][21]24,[41][42][43][44][45] A planificação de ato operató-rio por cirurgião experiente e a compreensão do que se fará, por parte do aprendiz, utilizando-se métodos visuais atrativos, principalmente se aliados à estereoscopia, podem fornecer meio preciso e rápido de aprendizado. A RV se presta a planificar operações de modo a utilizar melhores ângulos de vista com menor risco para o paciente.…”

Section: Realidade Virtual: Início E Emprego Em Neuroanatomia E Neurounclassified

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2013

Arq Bras Neurocir

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Planning and Simulation of Neurosurgery in a Virtual Reality Environment

Cited by 164 publications

References 37 publications

Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual reality planning using magnetic resonance angiography

Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual reality planning using magnetic resonance angiography

Image Overlay Guidance for Needle Insertion in CT Scanner

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