Related Experiment Videos
Measurement of intraoperative brain surface deformation under a craniotomy
D L Hill1, C R Maurer, R J Maciunas
1Division of Radiological Sciences and Medical Engineering, Guy's Hospital School of Medicine, London, England.
Neurosurgery
|September 11, 1998
Summary
Brain deformation during surgery causes significant spatial inaccuracies in image-guided surgery. This study quantified brain shift, revealing mean displacements up to 5.6 mm, highlighting its impact on surgical navigation accuracy.
Area of Science:
- Neurosurgery
- Medical Imaging
- Surgical Navigation
Background:
- Image-guided surgery (IGS) systems aim for high spatial accuracy.
- Potential errors include registration inaccuracies, image distortions, and instrument tracking errors.
- Brain deformation between imaging and surgery is a critical, yet often overlooked, source of error.
Purpose of the Study:
- To quantify the extent of brain and dura deformation.
- To measure the spatial displacement of brain surfaces from preoperative imaging to intraoperative resection.
- To assess the impact of this deformation on surgical navigation accuracy.
Main Methods:
- Intraoperative functional mapping was used in 21 patients.
- Brain surface positions were recorded and registered to preoperative MRI using the Acustar surgical navigation system.
- Measurements were taken after dura opening but before resection, approximately one hour apart.
Main Results:
- Mean displacements of 1.2 mm (dura), 4.4 mm (brain surface 1), and 5.6 mm (brain surface 2) were observed.
- Significant volume reductions under the craniotomy (up to 29 cc) accompanied the deformation.
- Maximum displacements exceeded 10 mm in a substantial portion of patients, indicating considerable brain shift.
Conclusions:
- Intraoperative brain deformation is a significant source of spatial error in image-guided surgery.
- These findings underscore the necessity of accounting for brain shift in surgical navigation.
- Further research into mitigating these errors is warranted.