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International Journal of Computer Assisted Radiology and Surgery

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01-10-2017 | Original Article

3D intra-operative ultrasound and MR image guidance: pursuing an ultrasound-based management of brainshift to enhance neuronavigation

Authors: Marco Riva, Christoph Hennersperger, Fausto Milletari, Amin Katouzian, Federico Pessina, Benjamin Gutierrez-Becker, Antonella Castellano, Nassir Navab, Lorenzo Bello

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 10/2017

Abstract

Background

Brainshift is still a major issue in neuronavigation. Incorporating intra-operative ultrasound (iUS) with advanced registration algorithms within the surgical workflow is regarded as a promising approach for a better understanding and management of brainshift. This work is intended to (1) provide three-dimensional (3D) ultrasound reconstructions specifically for brain imaging in order to detect brainshift observed intra-operatively, (2) evaluate a novel iterative intra-operative ultrasound-based deformation correction framework, and (3) validate the performance of the proposed image-registration-based deformation estimation in a clinical environment.

Methods

Eight patients with brain tumors undergoing surgical resection are enrolled in this study. For each patient, a 3D freehand iUS system is employed in combination with an intra-operative navigation (iNav) system, and intra-operative ultrasound data are acquired at three timepoints during surgery. On this foundation, we present a novel resolution-preserving 3D ultrasound reconstruction, as well as a framework to detect brainshift through iterative registration of iUS images. To validate the system, the target registration error (TRE) is evaluated for each patient, and both rigid and elastic registration algorithms are analyzed.

Results

The mean TRE based on 3D-iUS improves significantly using the proposed brainshift compensation compared to neuronavigation (iNav) before (2.7 vs. 5.9 mm; \(p=0.001\)) and after dural opening (4.2 vs. 6.2 mm, \(p=0.049\)), but not after resection (6.7 vs. 7.5 mm; \(p=0.426\)). iUS depicts a significant (\(p=0.001\)) dynamic spatial brainshift throughout the three timepoints. Accuracy of registration can be improved through rigid and elastic registrations by 29.2 and 33.3%, respectively, after dural opening, and by 5.2 and 0.4%, after resection.

Conclusion

3D-iUS systems can improve the detection of brainshift and significantly increase the accuracy of the navigation in a real scenario. 3D-iUS can thus be regarded as a robust, reliable, and feasible technology to enhance neuronavigation.

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Title: 3D intra-operative ultrasound and MR image guidance: pursuing an ultrasound-based management of brainshift to enhance neuronavigation
Authors: Marco Riva
Christoph Hennersperger
Fausto Milletari
Amin Katouzian
Federico Pessina
Benjamin Gutierrez-Becker
Antonella Castellano
Nassir Navab
Lorenzo Bello
Publication date: 01-10-2017
Publisher: Springer International Publishing
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 10/2017
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-017-1578-5

ACC 2024 Congress

Springer Medicine

3D intra-operative ultrasound and MR image guidance: pursuing an ultrasound-based management of brainshift to enhance neuronavigation

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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