Mapping Resection Progress by Tool-Tip Tracking during Brain Tumor Surgery for Real-Time Estimation of Residual Tumor

Area of Science:

• Neurosurgery
• Medical Imaging
• Surgical Navigation

Background:

• Surgical resection is the primary treatment for brain tumors.
• Current neuronavigation systems lose accuracy due to brain shift.
• Intraoperative MRI and ultrasound have limitations in resolution and timeliness.

Purpose of the Study:

• To present a novel system for generating a high-accuracy resection progress map using tool-tip positions.
• To evaluate the system's ability to estimate residual tumor during cranial tumor resections.

Main Methods:

• A system utilizing time-stamped surgical instrument tip positions to create a resection map.
• Evaluation of the system in 80 cranial tumor resections.
• Comparison of the system's residual tumor estimation (True Negative Tracking) with intraoperative MRI findings.

Main Results:

• The system provides accurate tracking of resection progress.
• Good estimates of residual tumor were achieved with minimal brain shift and maintained line-of-sight.
• Surgeons found the system useful for identifying potential residual tumor regions even when conditions were not optimal.

Conclusions:

• The presented system offers a valuable tool for monitoring brain tumor resection progress.
• It enhances surgical guidance by providing accurate, real-time resection mapping.
• The system shows promise in improving the assessment of residual tumor, especially when advanced intraoperative imaging is constrained.