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Published on: August 6, 2019
Automatic and efficient MRI-US segmentations for improving intraoperative image fusion in image-guided neurosurgery
J Nitsch1, J Klein2, P Dammann3
1Medical Image Computing, University of Bremen, Bremen, Germany; Fraunhofer MEVIS, Bremen, Germany; Surgical Planning Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Abstract:
Knowledge of the exact tumor location and structures at risk in its vicinity are crucial for neurosurgical interventions. Neuronavigation systems support navigation within the patient's brain, based on preoperative MRI (preMRI). However, increasing tissue deformation during the course of tumor resection reduces navigation accuracy based on preMRI. Intraoperative ultrasound (iUS) is therefore used as real-time intraoperative imaging. Registration of preMRI and iUS remains a challenge due to different or varying contrasts in iUS and preMRI. Here, we present an automatic and efficient segmentation of B-mode US images to support the registration process. The falx cerebri and the tentorium cerebelli were identified as examples for central cerebral structures and their segmentations can serve as guiding frame for multi-modal image registration. Segmentations of the falx and tentorium were performed with an average Dice coefficient of 0.74 and an average Hausdorff distance of 12.2 mm. The subsequent registration incorporates these segmentations and increases accuracy, robustness and speed of the overall registration process compared to purely intensity-based registration. For validation an expert manually located corresponding landmarks. Our approach reduces the initial mean Target Registration Error from 16.9 mm to 3.8 mm using our intensity-based registration and to 2.2 mm with our combined segmentation and registration approach. The intensity-based registration reduced the maximum initial TRE from 19.4 mm to 5.6 mm, with the approach incorporating segmentations this is reduced to 3.0 mm. Mean volumetric intensity-based registration of preMRI and iUS took 40.5 s, including segmentations 12.0 s.
Insights
This study introduces an automated segmentation method for intraoperative ultrasound (iUS) images to improve the accuracy of neurosurgical navigation. By segmenting key brain structures, the approach significantly reduces registration errors between preoperative MRI and iUS, enhancing surgical precision.
Area of Science:
- Neurosurgery
- Medical Imaging
- Image Processing
Background:
- Accurate neurosurgical navigation relies on precise tumor localization and identification of critical surrounding structures.
- Preoperative MRI (preMRI) based neuronavigation accuracy degrades due to intraoperative tissue deformation.
- Intraoperative ultrasound (iUS) offers real-time imaging but faces registration challenges with preMRI due to contrast variations.
Purpose of the Study:
- To develop an automatic and efficient segmentation method for B-mode ultrasound images.
- To enhance the registration process between preMRI and iUS for improved neuronavigation accuracy.
- To utilize segmentations of central cerebral structures (falx cerebri, tentorium cerebelli) as a guiding frame for multi-modal image registration.
Main Methods:
- Automatic segmentation of the falx cerebri and tentorium cerebelli in B-mode ultrasound images.
- Development of a multi-modal image registration approach combining intensity-based methods with structural segmentations.
- Validation using expert-identified landmarks to quantify Target Registration Error (TRE).
Main Results:
- Segmentation of falx and tentorium achieved an average Dice coefficient of 0.74 and Hausdorff distance of 12.2 mm.
- The combined segmentation and registration approach reduced mean TRE from 16.9 mm to 2.2 mm.
- Registration time was significantly reduced from 40.5 s (intensity-based) to 12.0 s (combined approach).
Conclusions:
- Automatic segmentation of cerebral structures in iUS is feasible and effective for improving preMRI-iUS registration.
- The proposed method enhances the accuracy, robustness, and speed of neuronavigation systems.
- This technique holds significant potential for improving surgical precision in neurosurgical interventions.
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