Top

Acta Neurochirurgica

Published in:

01-02-2018 | Original Article - Brain Tumors

Technical accuracy of the integration of an external ultrasonography system into a navigation platform: effects of ultrasonography probe registration and target detection

Authors: Frederic A. Wanis, Lars Wessels, Marcus H. T. Reinges, Eberhard Uhl, Andreas Jödicke

Published in: Acta Neurochirurgica | Issue 2/2018

Abstract

Background

Intraoperative navigated ultrasonography has reached clinical acceptance, while published data for the accuracy of some systems are missing. We technically quantified and optimised the accuracy of the integration of an external ultrasonography system into a BrainLab navigation system.

Methods

A high-end ultrasonography system (Elegra; Siemens, Erlangen, Germany) was linked to a navigation system (Vector Vision; BrainLab, Munich, Germany). In vitro accuracy and precision was calculated from differences between a real world target (high-precision crosshair phantom) and the ultrasonography image of this target in the navigation coordinate system. The influence of the intrinsic component of the calibration phantom (for ultrasonography probe registration), type of target definition (manual versus automatic) and orientation of the ultrasound probe in relation to the navigation tracking device on accuracy and precision were analysed in different settings (100 measurements for each setting) resembling clinically relevant scenarios in the neurosurgical operating theatre.

Results

Line-of-sight angles of 45°, 62° and 90° for the optical tracking of the navigated ultrasonography probe and a distance of 1.8 m revealed best accuracy and precision. Technical accuracy of the integration of ultrasonography into a standard navigation system is high [Euclidean error: median, 0.79 mm; mean, 0.89 ± 0.42 mm for 62° angle; median range: 1.16–1.46 mm; mean range (±SD): 1.22 ± 0.32 mm to 1.46 ± 0.55 mm for grouped analysis of all angles tested]. Software-based automatic target definition improved precision significantly (p < 0.001).

Conclusions

Integration of an external ultrasonography system into the BrainLab navigation is accurate and precise. By modifying registration (and measurement conditions) via software modification, the in vitro accuracy and precision is improved and requirements for a clinical application are fully met.

Black PM, Moriarty T, Alexander E, Stieg P, Woodard EJ, Gleason PL, Martin CH, Kikinis R, Schwartz RB, Jolesz FA (1997) Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery 41(4):831–842 discussion 842–845CrossRefPubMed

Bucholz RD, Yeh DD, Trobaugh J, McDurmont LL, Sturm CD, Baumann C, Henderson JM, Levy A, Kessman P (2005) The correction of stereotactic inaccuracy caused by brain shift using an intraoperative ultrasound device. In: CVRMed-MRCAS'97. Springer, Berlin Heidelberg, pp. 459–466

Chacko AG, Kumar NKS, Chacko G, Athyal R, Rajshekhar V (2003) Intraoperative ultrasound in determining the extent of resection of parenchymal brain tumours—a comparative study with computed tomography and histopathology. Acta Neurochir 145(9):743–748 discussion 748CrossRefPubMed

Comeau RM, Sadikot AF, Fenster A, Peters TM (2000) Intraoperative ultrasound for guidance and tissue shift correction in image-guided neurosurgery. Med Phys 27(4):787–800CrossRefPubMed

Dorward NL, Alberti O, Velani B, Gerritsen FA, Harkness WF, Kitchen ND, Thomas DG (1998) Postimaging brain distortion: magnitude, correlates, and impact on neuronavigation. J Neurosurg 88(4):656–662CrossRefPubMed

Giorgi C, Casolino DS (1997) Preliminary clinical experience with intraoperative stereotactic ultrasound imaging. Stereotact Funct Neurosurg 68(1–4 Pt 1):54–58CrossRefPubMed

Hammoud MA, Ligon BL, elSouki R, Shi WM, Schomer DF, Sawaya R (1996) Use of intraoperative ultrasound for localizing tumors and determining the extent of resection: a comparative study with magnetic resonance imaging. J Neurosurg 84(5):737–741CrossRefPubMed

Hartov A, Eisner SD, David RW, Paulsen KD, Platenik LA, Miga MI (1999) Error analysis for a free-hand three-dimensional ultrasound system for neuronavigation. Neurosurg Focus 6(3):E7CrossRef

Hata N, Dohi T, Iseki H, Takakura K (1997) Development of a frameless and armless stereotactic neuronavigation system with ultrasonographic registration. Neurosurgery 41(3):608–613 discussion 613–614PubMed

10.

Hirschberg H, Unsgaard G (1997) Incorporation of ultrasonic imaging in an optically coupled frameless stereotactic system. Acta Neurochir Suppl 68:75–80PubMed

11.

Hu J, Jin X, Lee JB, Zhang L, Chaudhary V, Guthikonda M, Yang KH, King AI (2007) Intraoperative brain shift prediction using a 3D inhomogeneous patient-specific finite element model. J Neurosurg 106(1):164–169CrossRefPubMed

12.

Jödicke A, Deinsberger W, Erbe H, Kriete A, Böker D-K (1998) Intraoperative three-dimensional ultrasonography: an approach to register brain shift using multidimensional image processing. Minim Invasive Neurosurg 41(1):13–19CrossRefPubMed

13.

Jödicke A, Springer T, Böker D-K (2004) Real-time integration of ultrasound into neuronavigation: technical accuracy using a light-emitting-diode-based navigation system. Acta Neurochir 146(11):1211–1220CrossRefPubMed

14.

Keles GE, Lamborn KR, Berger MS (2003) Coregistration accuracy and detection of brain shift using intraoperative sononavigation during resection of hemispheric tumors. Neurosurgery 53(3):556–562 discussion 562–564CrossRefPubMed

15.

Koivukangas J, Louhisalmi Y, Alakuijala J, Oikarinen J (1993) Ultrasound-controlled neuronavigator-guided brain surgery. J Neurosurg 79(1):36–42CrossRefPubMed

16.

Koivukangas J, Ylitalo J, Alasaarela E, Tauriainen A (1986) Three-dimensional ultrasound imaging of brain for neurosurgery. Ann Clin Res 18 Suppl 47:65–72PubMed

17.

Le Roux PD, Berger MS, Wang K, Mack LA, Ojemann GA (1992) Low grade gliomas: comparison of intraoperative ultrasound characteristics with preoperative imaging studies. J Neuro-Oncol 13(2):189–198CrossRef

18.

Lindner D, Trantakis C, Renner C, Arnold S, Schmitgen A, Schneider J, Meixensberger J (2006) Application of intraoperative 3D ultrasound during navigated tumor resection. Minim Invasive Neurosurg 49(4):197–202CrossRefPubMed

19.

Lindseth F, Langø T, Bang J, Nagelhus Hernes TA (2002) Accuracy evaluation of a 3D ultrasound-based Neuronavigation system. Comput Aided Surg 7(4):197–222CrossRefPubMed

20.

Moiyadi AV, Shetty PM, Mahajan A, Udare A, Sridhar E (2013) Usefulness of three-dimensional navigable intraoperative ultrasound in resection of brain tumors with a special emphasis on malignant gliomas. Acta Neurochir 155(12):2217–2225CrossRefPubMed

21.

Muratore DM, Galloway RL (2001) Beam calibration without a phantom for creating a 3-D freehand ultrasound system. Ultrasound Med Biol 27(11):1557–1566CrossRefPubMed

22.

Nabavi A, Black PM, Gering DT et al (2001) Serial intraoperative magnetic resonance imaging of brain shift. Neurosurgery 48(4):787–797 discussion 797–798PubMed

23.

Nimsky C, Ganslandt O, Cerny S, Hastreiter P, Greiner G, Fahlbusch R (2000) Quantification of, visualization of, and compensation for brain shift using intraoperative magnetic resonance imaging. Neurosurgery 47(5):1070–1079 discussion 1079–1080CrossRefPubMed

24.

Pennec X, Cachier P, Ayache N (2003) Tracking brain deformations in time sequences of 3D US images. Pattern Recogn Lett 24(4–5):801–813CrossRef

25.

Petridis AK, Anokhin M, Vavruska J, Mahvash M, Scholz M (2015) The value of intraoperative sonography in low grade glioma surgery. Clin Neurol Neurosurg 131:64–68CrossRefPubMed

26.

Prada F, Del Bene M, Mattei L, Lodigiani L, DeBeni S, Kolev V, Vetrano I, Solbiati L, Sakas G, DiMeco F (2015) Preoperative magnetic resonance and intraoperative ultrasound fusion imaging for real-time neuronavigation in brain tumor surgery. Ultraschall Med 36(2):174–186PubMed

27.

Reinges MHT, Nguyen H-H, Krings T, Hütter B-O, Rohde V, Gilsbach JM (2004) Course of brain shift during microsurgical resection of supratentorial cerebral lesions: limits of conventional neuronavigation. Acta Neurochir 146(4):369–377 discussion 377CrossRefPubMed

28.

Schlaier JR, Warnat J, Dorenbeck U, Proescholdt M, Schebesch K-M, Brawanski A (2004) Image fusion of MR images and real-time ultrasonography: evaluation of fusion accuracy combining two commercial instruments, a neuronavigation system and a ultrasound system. Acta Neurochir 146(3):271–276 discussion 276–277CrossRefPubMed

29.

Sergeeva O, Uhlemann F, Schackert G, Hergeth C, Morgenstern U, Steinmeier R (2006) Integration of intraoperative 3D-ultrasound in a commercial navigation system. Zentralbl Neurochir 67(4):197–203CrossRefPubMed

30.

Serra C, Stauffer A, Actor B, Burkhardt J-K, Ulrich NH-B, Bernays R-L, Bozinov O (2012) Intraoperative high frequency ultrasound in intracerebral high-grade tumors. Ultraschall Med 33(7):E306–E312CrossRefPubMed

31.

Singhal A, Ross Hengel A, Steinbok P, Doug Cochrane D (2015) Intraoperative ultrasound in pediatric brain tumors: does the surgeon get it right? Childs Nerv Syst 31(12):2353–2357CrossRefPubMed

32.

Stieglitz LH, Fichtner J, Andres R, Schucht P, Krähenbühl A-K, Raabe A, Beck J (2013) The silent loss of neuronavigation accuracy: a systematic retrospective analysis of factors influencing the mismatch of frameless stereotactic systems in cranial neurosurgery. Neurosurgery 72(5):796–807CrossRefPubMed

33.

Trantakis C, Meixensberger J, Lindner D, Strauss G, Grunst G, Schmidtgen A, Arnold S (2002) Iterative neuronavigation using 3D ultrasound. A feasibility study. Neurol Res 24(7):666–670CrossRefPubMed

34.

Trobaugh JW, Trobaugh DJ, Richard WD (1994) Three-dimensional imaging with stereotactic ultrasonography. Comput Med Imaging Graph 18(5):315–323CrossRefPubMed

35.

Tronnier VM, Bonsanto MM, Staubert A, Knauth M, Kunze S, Wirtz CR (2001) Comparison of intraoperative MR imaging and 3D-navigated ultrasonography in the detection and resection control of lesions. Neurosurg Focus 10(2):E3CrossRefPubMed

36.

Unsgaard G, Rygh OM, Selbekk T, Müller TB, Kolstad F, Lindseth F, Hernes TAN (2006) Intra-operative 3D ultrasound in neurosurgery. Acta Neurochir 148(3):235–253 discussion 253CrossRefPubMed

37.

Unsgaard G, Gronningsaeter A, Ommedal S, Nagelhus Hernes TA (2002) Brain operations guided by real-time two-dimensional ultrasound: new possibilities as a result of improved image quality. Neurosurgery 51(2):402–411 discussion 411–412CrossRefPubMed

38.

Vince G, Krone A, Woydt M, Roosen K (1998) Real time ultrasound fusion in optical tracking MR/CT image guided surgery. In: Proceedings of the XIII Congress of the European Society for Stereotactic and Functional Neurosurgery, Freiburg, 20-23 September 1998

39.

Woydt M, Krone A, Becker G, Schmidt K, Roggendorf W, Roosen K (1996) Correlation of intra-operative ultrasound with histopathologic findings after tumour resection in supratentorial gliomas. A method to improve gross total tumour resection. Acta Neurochir 138(12):1391–1398CrossRefPubMed

40.

Zagzebski JA (1996) Essentials of ultrasound physics. Mosby, St. Louis, p 40

Title: Technical accuracy of the integration of an external ultrasonography system into a navigation platform: effects of ultrasonography probe registration and target detection
Authors: Frederic A. Wanis
Lars Wessels
Marcus H. T. Reinges
Eberhard Uhl
Andreas Jödicke
Publication date: 01-02-2018
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 2/2018
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-017-3416-5

At a glance: The STEP trials

Springer Medicine

Technical accuracy of the integration of an external ultrasonography system into a navigation platform: effects of ultrasonography probe registration and target detection

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Successful retinal blood flow augmentation after extracranial-intracranial bypass

Decompressive craniectomy in traumatic brain injury: usage and clinical outcome in a single centre

Manipulating an internal pulse generator until twiddler’s syndrome in a patient treated with deep brain stimulation for obsessive-compulsive disorder

Aphasia and cognitive impairment decrease the reliability of rnTMS language mapping

Transcondylar approach for resection of lateral medullary cavernous malformation

Flexible endoscopically assisted evacuation of acute and subacute subdural hematoma through a small craniotomy: preliminary results