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Clinical Validation of Intraoperative Ultrasound-Based Automated Rigid Image Fusion to Update Neuronavigation Using

Aliasgar V Moiyadi^1,2, Prakash Shetty^1,2, Vikas Singh^1,2

¹Neurosurgery Services, Department of Surgical Oncology, Tata Memorial Centre, Mumbai , India.

Operative Neurosurgery (Hagerstown, Md.)

|March 17, 2025

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This summary is machine-generated.

Automated rigid image fusion (RIF) using intraoperative ultrasound significantly improves navigation accuracy for brain tumor surgery compared to traditional methods. This technique enhances precision during various surgical stages, aiding surgeons in achieving better outcomes.

Area of Science:

Neurosurgery
Medical Imaging
Image-Guided Therapy

Background:

MRI-based neuronavigation accuracy can be limited.
Navigated 3D intraoperative ultrasound (iUS) offers potential compensation.
Automated rigid image fusion (RIF) integrates MRI and iUS data.

Purpose of the Study:

To evaluate the accuracy of an automated RIF application for navigated iUS.
To assess RIF performance at different surgical stages.
To analyze factors influencing RIF accuracy.

Main Methods:

Twenty-five adult glioma patients underwent surgery with navigated iUS.
Target registration error (TRE) was quantified postoperatively.
Linear mixed models analyzed TRE and RIF performance across surgical stages (BDO, ADO, APR, ACR).

Keywords:

Brain shift Brain tumor Image coregistration Intraoperative imaging Intraoperative ultrasound Neuronavigation Resection guidance

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Main Results:

RIF significantly reduced mean TRE from 4.7 mm to 3.5 mm (P < .002).
TRE reduction was significant at pre-resection stages (BDO, ADO, APR) but not post-resection (ACR).
RIF improved TRE independent of tumor factors and enhanced accuracy with prealignment errors up to ±15 mm.

Conclusions:

Automated RIF with navigated iUS enhances registration accuracy in intra-axial tumor surgery.
The technique provides reliable accuracy in pre-resection and some post-resection surgical phases.
RIF is a valuable tool for improving image-guided neurosurgical procedures.