Capturing Intraoperative Deformations: Research Experience At The Surgical Planning Laboratory

S. K. Warfield, S. J. Haker, I.-F. Talos, C. A. Kemper, N. Weisenfeld, A. Mewes, D. Goldberg-Zimring, K. H. Zou, C.-F. Westin, W. M. Wells, C. M. C. Tempany, A. Golby, P. M. Black, F. A. Jolesz, R. Kikinis
Medical Image Analysis
Volume 9, Pages 145-162
2005

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Abstract

During neurosurgical procedures the objective of the neurosurgeon is to achieve the resection of as much diseased tissue as possible while achieving the preservation of healthy brain tissue. The restricted capacity of the conventional operating room to enable the surgeon to visualize critical healthy brain structures and tumor margin has lead, over the past decade, to the development of sophisticated intraoperative imaging techniques to enhance visualization. However, both rigid motion due to patient placement and nonrigid deformations occurring as a consequence of the surgical intervention disrupt the correspondence between preoperative data used to plan surgery and the intraoperative configuration of the patient's brain. Similar challenges are faced in other interventional therapies, such as in cryoablation of the liver, or biopsy of the prostate. We have developed algorithms to model the motion of key anatomical structures and system implementations that enable us to estimate the deformation of the critical anatomy from sequences of volumetric images and to prepare updated fused visualizations of preoperative and intraoperative images at a rate compatible with surgical decision making. This paper reviews the experience at Brigham and Women's Hospital through the process of developing and applying novel algorithms for capturing intraoperative deformations in support of image guided therapy.

(a) Axial MRimage. (b) Multi-modality visualization. The axial MRimage shows the region of a tumor, and on the basis of the appearance of the solid circular region of abnormal signal intensity associated with the tumor, it could be inferred that it is safe to remove this tumor in its entirety. Upon comparing this with the visualization on the right that shows functional MRI activation of a motor task in red, motor related fiber tracts in yellow, lateral ventricles in blue, and the region of the tumor in green, we can see that it is possible to trace fiber tracts from the brain stem up through the tumor to the motor cortex. Such information may alter the perceived risks versus benefits assessment involved in total resection of the tumor.

Reference

Warfield SK, Haker SJ, Talos IF, Kemper CA, Weisenfeld N, Mewes A, Goldberg-Zimring D, Zou KH, Westin CF, Wells WM, Tempany CMC, Golby A, Black PM, Jolesz FA, Kikinis R. Capturing intraoperative deformations: Research experience at the surgical planning laboratory. Medical Image Analysis 2005;9:145-162.

Bibtex entry

@Article{warfieldMEDIA05,
  author         = {S. K. Warfield and S. J. Haker and I.-F. Talos and C. A.   
                   Kemper  and N. Weisenfeld and A. Mewes and D.               
                   Goldberg-Zimring and K. H. Zou and C.-F. Westin and W. M.   
                   Wells and C. M. C. Tempany and A. Golby and  P. M. Black and
                   F. A. Jolesz and R. Kikinis},                               
  title          = {Capturing Intraoperative Deformations: Research Experience 
                   At  The Surgical Planning Laboratory},                      
  journal        = {Medical Image Analysis},                                   
  year           = {2005},                                                     
  volume         = {9},                                                        
  pages          = {145--162}
}

Grants

NIH R21-MH67054, NIH R01-LM007861, NIH P41-RR13218 (NAC), NIH P01-CA67165, NIH R01-AG19513, NIH R33-CA99015

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