Volumetric Measurements of Brain Shift Using Intraoperative Cone-Beam Computed Tomography

Pereira, Vítor Mendes; Smit-Ockeloen, Iris; Brina, Olivier; Babić, Draženko; Breeuwer, Marcel; Schaller, Karl; Lövblad, Karl-Olof; Ruijters, Daniël

doi:10.1227/neu.0000000000000999

Cited by 15 publications

(9 citation statements)

References 26 publications

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“…Optical topographical imaging would allow significantly faster automated surface registration for open lateral skull base procedures, while maintaining functionality using an operating microscope. In the short-term, rapid optical topographical imaging allows for frequent repeat registrations, minimizing the significant target registration errors seen with existing neuronavigation technologies as a result of progressive brain shift during the procedure 29 . Frameless stereotactic navigation is also employed routinely in otolaryngology, with growing applications in orthopedic, abdominal, and craniomaxillofacial procedures 15 , 30 – 32 .…”

Section: Discussionmentioning

confidence: 99%

High Speed, High Density Intraoperative 3D Optical Topographical Imaging with Efficient Registration to MRI and CT for Craniospinal Surgical Navigation

Jakubovic

Guha

Gupta

et al. 2018

Sci Rep

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Intraoperative image-guided surgical navigation for craniospinal procedures has significantly improved accuracy by providing an avenue for the surgeon to visualize underlying internal structures corresponding to the exposed surface anatomy. Despite the obvious benefits of surgical navigation, surgeon adoption remains relatively low due to long setup and registration times, steep learning curves, and workflow disruptions. We introduce an experimental navigation system utilizing optical topographical imaging (OTI) to acquire the 3D surface anatomy of the surgical cavity, enabling visualization of internal structures relative to exposed surface anatomy from registered preoperative images. Our OTI approach includes near instantaneous and accurate optical measurement of >250,000 surface points, computed at >52,000 points-per-second for considerably faster patient registration than commercially available benchmark systems without compromising spatial accuracy. Our experience of 171 human craniospinal surgical procedures, demonstrated significant workflow improvement (41 s vs. 258 s and 794 s, p < 0.05) relative to benchmark navigation systems without compromising surgical accuracy. Our advancements provide the cornerstone for widespread adoption of image guidance technologies for faster and safer surgeries without intraoperative CT or MRI scans. This work represents a major workflow improvement for navigated craniospinal procedures with possible extension to other image-guided applications.

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Section: Discussionmentioning

confidence: 99%

High Speed, High Density Intraoperative 3D Optical Topographical Imaging with Efficient Registration to MRI and CT for Craniospinal Surgical Navigation

Jakubovic

Guha

Gupta

et al. 2018

Sci Rep

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“…For these reasons, this intraoperative modality is thus rarely used in clinical routine. Pereira et al (2016) proposed to use pre-and intraoperative Cone-Beam Computed Tomography (CBCT) enhanced with intravenous injection of contrast agent. The volumetric deformation vector field was computed combining first a rigid registration of the skull then an elastic transformation based on vessels, ventricles and image intensities.…”

Section: Brain-shift Compensation Methods For Brain Tumor Surgerymentioning

confidence: 99%

Brain-shift compensation using intraoperative ultrasound and constraint-based biomechanical simulation

Morin

Courtecuisse

Reinertsen

et al. 2017

Medical Image Analysis

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“…As such, there is a need to incorporate intraprocedural measurements of brain shift into the neuronavigation process in order to update the interpretation of preoperative imaging to reflect intraoperative conditions. Various approaches, including intraoperative MRI (iMRI), cone‐beam CT, biomechanical modeling and computation, and stereo cameras have been proposed as solutions to this problem. Compared to other imaging modalities, the use of intraoperative US (ioUS) is attractive due to its low cost, minimal interruption of the operative flow, and lack of radiation exposure.…”

Section: Ultrasound Applicationsmentioning

confidence: 99%

Applications of Ultrasound in the Resection of Brain Tumors

Sastry

Pieper³

et al. 2016

Journal of Neuroimaging

132

138

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Neurosurgery makes use of pre-operative imaging to visualize pathology, inform surgical planning, and evaluate the safety of selected approaches. The utility of pre-operative imaging for neuronavigation, however, is diminished by the well characterized phenomenon of brain shift, in which the brain deforms intraoperatively as a result of craniotomy, swelling, gravity, tumor resection, cerebrospinal fluid (CSF) drainage, and many other factors. As such, there is a need for updated intraoperative information that accurately reflects intraoperative conditions. Since 1982, intraoperative ultrasound has allowed neurosurgeons to craft and update operative plans without ionizing radiation exposure or major workflow interruption. Continued evolution of ultrasound technology since its introduction has resulted in superior imaging quality, smaller probes, and more seamless integration with neuronavigation systems. Furthermore, the introduction of related imaging modalities, such as 3-dimensional ultrasound, contrast-enhanced ultrasound, high-frequency ultrasound, and ultrasound elastography have dramatically expanded the options available to the neurosurgeon intraoperatively. In the context of these advances, we review the current state, potential, and challenges of intraoperative ultrasound for brain tumor resection. We begin by evaluating these ultrasound technologies and their relative advantages and disadvantages. We then review three specific applications of these ultrasound technologies to brain tumor resection: (1) intraoperative navigation, (2) assessment of extent of resection, and (3) brain shift monitoring and compensation. We conclude by identifying opportunities for future directions in the development of ultrasound technologies.

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Volumetric Measurements of Brain Shift Using Intraoperative Cone-Beam Computed Tomography

Abstract: Contrast-enhanced cone-beam computed tomography provides a feasible technique for intraoperatively determining brain shift deformation vector fields. This technique can be used perioperatively to adjust preoperative planning and coregistration during neurosurgical procedures.

Cited by 15 publications

References 26 publications

High Speed, High Density Intraoperative 3D Optical Topographical Imaging with Efficient Registration to MRI and CT for Craniospinal Surgical Navigation

High Speed, High Density Intraoperative 3D Optical Topographical Imaging with Efficient Registration to MRI and CT for Craniospinal Surgical Navigation

Brain-shift compensation using intraoperative ultrasound and constraint-based biomechanical simulation

Applications of Ultrasound in the Resection of Brain Tumors

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