Serial Intraoperative MR Imaging of Brain Shift

A. Nabavi, P. Mc. L. Black, D. T. Gering, C.-F. Westin, V. Metha, R. S. Pergolizzi, Jr., M. Ferrant, S. K. Warfield, N. Hata, R. B. Schwarts, W. M. Wells, R. Kikinis, F. A. Jolesz
Neurosurgery
Volume 48, Pages 787-798
2001

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Abstract

Introduction: The major shortcoming of image-guided navigational systems is the use of presurgically acquired image data, which does not account for intraoperative changes in brain morphology. The occurrence of these surgically induced volumetric deformations, or "brain shift", has been well established. Maximum measurements for surface and midline shifts were reported. There is no detailed analysis, however, of the changes occurring throughout the entire surgery. Intraoperative MRI provides a unique opportunity to obtain serial imaging data and characterize the time course of brain deformations during surgery. Methods: The vertically open-configuration (0.5 Tesla SignaSP, GE Medical Systems) intraoperative MRI system permits access to the operative field and allows multiple intraoperative image updates without the need of moving the patient. We developed volumetric display software, the "3D Slicer", which allows quantitative analysis of degree and direction of brain shift. On twenty-five patients, four or more volumetric intraoperative image acquisitions were extensively evaluated.

Color-coded models for the evaluation of successive surface deformations. The brain surfaces were extracted from the 3D volume SPGRs for all time points. The surface displacement from stage to stage was automatically calculated and color-coded. The color encodes depths from red (0 mm) to green (2.5 cm) to blue (5 cm). The color-coding was projected onto the model of the brain at that respective stage of the surgery.

Reference

Nabavi A, Black PML, Gering DT, Westin CF, Metha V, Pergolizzi RS, Jr, Ferrant M, Warfield SK, Hata N, Schwarts RB, Wells WM, Kikinis R, Jolesz FA. Serial intraoperative mr imaging of brain shift. Neurosurgery 2001;48:787-798.

Bibtex entry

@Article{nabaviNEUROSURGERY01,
  author         = {A. Nabavi and P. Mc. L. Black and D. T. Gering and C.-F.   
                   Westin  and V. Metha and R. S. Pergolizzi and Jr. and M.    
                   Ferrant and  S. K. Warfield and N. Hata and R. B. Schwarts  
                   and W. M. Wells  and R. Kikinis and F. A. Jolesz},          
  title          = {Serial Intraoperative MR Imaging of Brain Shift},          
  journal        = {Neurosurgery},                                             
  year           = 2001,                                                       
  volume         = 48,                                                         
  pages          = {787--798}
}

Grants

NIH P41-RR13218 (NAC), NIH P01-CA67165

Research area

Neurosurgery