Three-dimensional localization: from image-guided surgery to information-guided therapy

Image-guided surgery has become the standard of care for intracranial procedures. However, significant development is required before the benefits of this technology are brought to the majority of patients undergoing surgery. This article categorizes the areas wherein progress is needed, and indicates recent advances that may form the basis for the broad acceptance of this exciting technology. Emphasis is placed on a technique whereby preoperative imaging can be updated using low-resolution intraoperative imaging to reflect changes in anatomy caused by surgery, and on transforming image-guided surgery to information-guided therapy, in which diverse sources can be brought to bear at the time of greatest possible benefit, when the patient's anatomy is exposed for therapeutic intervention.