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New Protocol for Skin Landmark Registration in Image-Guided Neurosurgery: Technical Note
Ian J Gerard1, Jeffery A Hall, Kelvin Mok
1*McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada; ‡Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada; §Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; ¶Neuronavigation Unit, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada.
Using 8 landmarks for patient-to-image registration, a protocol with 4 ear and 4 facial landmarks significantly reduced target registration error compared to other 8-landmark and 9-landmark protocols.
Area of Science:
- Neurosurgery
- Medical Imaging
- Surgical Navigation
Background:
- Newer Medtronic StealthStation systems utilize 8 landmark pairs for patient-to-image registration, unlike older systems with 9 pairs.
- The selection of landmark pairs in 8-pair protocols can impact registration accuracy.
Purpose of the Study:
- To evaluate 4 distinct 8-landmark registration protocols.
- To compare the accuracy of these 8-landmark protocols against a standard 9-landmark protocol.
Main Methods:
- Four 8-landmark protocols were tested on phantoms and patients.
- Two protocols used 4 ear and 4 facial landmarks; two used 3 ear and 5 facial landmarks.
- Fiducial registration error (FRE) and target registration error (TRE) were assessed for all protocols.
Main Results:
- No significant difference in FRE was observed between any 8-landmark protocols and the 9-landmark protocol.
- A significant reduction in TRE (P < .05) was achieved with the 4 ear/4 facial landmark protocol compared to other 8-landmark protocols.
- The 4 ear/4 facial landmark protocol also showed lower TRE than the 9-landmark protocol.
Conclusions:
- The 8-landmark protocol employing 4 ear and 4 facial landmarks demonstrates superior performance in patient-to-image registration.
- This specific 8-landmark protocol yields the lowest target registration error, outperforming other 8-landmark and the 9-landmark approaches.
