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Surface-based facial scan registration in neuronavigation procedures: a clinical study.

Reuben R Shamir1, Moti Freiman, Leo Joskowicz

  • 1School of Engineering and Computer Science, Hebrew University, Givat Ram Campus, Jerusalem, Israel 91904. rubke@cs.huji.ac.il

Journal of Neurosurgery
|April 28, 2009
PubMed
Summary

Surface-based registration (SBR) using facial scans is a practical alternative for neurosurgery navigation. Accuracy is best near the face, with error increasing for deeper targets, but the method is feasible intraoperatively.

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Image-guided Navigation

Background:

  • Surface-based registration (SBR) is an emerging alternative to fiducial-based registration in image-guided neurosurgery.
  • Previous comparisons of SBR and fiducial-based registration have limitations in target selection and lack visual feedback on registration error.
  • Surgeons need accurate and reliable methods for target localization during neurosurgical procedures.

Purpose of the Study:

  • To quantify the accuracy of SBR in a clinical neurosurgery setting.
  • To estimate the target registration error (TRE) for various intracranial target locations.
  • To develop a visual map of estimated TRE for intraoperative guidance.

Main Methods:

  • 12 neurosurgery patients (supine and lateral positions) underwent navigation using a commercial system.

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  • Intraoperative facial surface scans were acquired and aligned with preoperative MR/CT images.
  • SBR accuracy was assessed on the facial surface and estimated for intracranial targets, with TRE contours visualized on patient images.

    • Main Results:

    • Mean surface registration error on the face was 0.9 +/- 0.35 mm.
    • Estimated mean TREs at 60, 105, and 150 mm from the facial surface were 2.0, 3.2, and 4.5 mm, respectively.
    • Registration procedure, including scanning and computation, typically took under 5 minutes.

    Conclusions:

    • SBR accuracy is highest in facial and frontal regions, with error increasing with target depth.
    • Visualizing anisotropic TRE distribution can aid surgical decision-making.
    • SBR with a fast surface scanner is clinically practical and feasible, offering acceptable accuracy and speed.