An Integrated Visualization System for Surgical Planning and Guidance Using Image Fusion and Interventional Imaging

Abstract

Abstract. We present a software package which uniquely integrates several facets of image-guided medicine into a single portable, extendable environment. It provides capabilities for automatic registration, semiautomatic segmentation, 3D surface model generation, 3D visualization, and quantitative analysis of various medical scans. We describe its system architecture, wide range of applications, and novel integration with an interventional Magnetic Resonance (MR) scanner to augment intraoperative imaging with pre-operative data. Analysis previously reserved for pre-operative data can now be applied to exploring the anatomical changes as the surgery progresses. Surgical instruments are tracked and used to drive the location of reformatted slices. Real-time scans are visualized as slices in the same 3D view along with the pre-operative slices and surface models. The system has been applied in over 20 neurosurgical cases at Brigham and Women's Hospital, and continues to be routinely used for 1-3 cases per week.

Serial registration of intraoperative MR images of the brain

“…This means we can use segmentation approaches that are robust and accurate but are time consuming and hence impractical to use in the operating room. In our laboratory, preoperative data is segmented with a variety of manual (Gering et al, 1999), semi-automated (Kikinis et al, 1992) or automated (Warfield et al, 1995Kaus et al, 2000) approaches. We select the most robust and accurate approach available for a given clinical application.…”

Multi-trajectories automatic planner for StereoElectroEncephaloGraphy (SEEG)

“…Freesurfer is used for brain segmentation and hemisphere splitting [9,12]. 3D Slicer is used to create the multimodal scenes [16]. The local Ethical Committee has approved the present study.…”

Virtual coronary cineangiography

“…al in [9] present a software package which uniquely integrates several facets of image-guided medicine into a single portable, extendable environment. They present its usability through tree use-cases: pre-operative analysis and planning, surgical guidance, and volumetric analysis and studies of dynamics.…”