Combining intraoperative ultrasound brain shift correction and augmented reality visualizations: a pilot study of eight cases

Abstract

We present our work investigating the feasibility of combining intraoperative ultrasound for brain shift correction and augmented reality (AR) visualization for intraoperative interpretation of patient-specific models in image-guided neurosurgery (IGNS) of brain tumors. We combine two imaging technologies for image-guided brain tumor neurosurgery. Throughout surgical interventions, AR was used to assess different surgical strategies using three-dimensional (3-D) patient-specific models of the patient's cortex, vasculature, and lesion. Ultrasound imaging was acquired intraoperatively, and preoperative images and models were registered to the intraoperative data. The quality and reliability of the AR views were evaluated with both qualitative and quantitative metrics. A pilot study of eight patients demonstrates the feasible combination of these two technologies and their complementary features. In each case, the AR visualizations enabled the surgeon to accurately visualize the anatomy and pathology of interest for an extended period of the intervention. Inaccuracies associated with misregistration, brain shift, and AR were improved in all cases. These results demonstrate the potential of combining ultrasound-based registration with AR to become a useful tool for neurosurgeons to improve intraoperative patient-specific planning by improving the understanding of complex 3-D medical imaging data and prolonging the reliable use of IGNS.

Augmented reality in neurosurgical navigation: A survey

“…Gerard et al 7 1-3 mm 8 patients Martirosyan et al 36 ICG solution (0.3 mg/kg) was injected into the jugular vein, and fluorescent femoral artery flow was observed.…”

“…Gerard et al 7,8 AR US I The advantages of combined intraoperative ultrasound and AR resection of coronary tumours were described.…”

“…It will reduce the effectiveness of the model of the preoperative patient used during surgery. Kersten‐Oertel and Gerard et al 7 , 66 combine intraoperative ultrasound (iUS) and AR with traditional NSSs to process and visualize MRI to improve accuracy during surgery. All images and models were imported into the IBIS 9 (a specific NSS) console before the patient was brought into the operating room.…”

Computational Biomechanics of the Brain in the Operating Theatre

“…The most straightforward solution is to use the deformation field derived from the brain shift modeling to map the pre-operative MRI image to the patient's brain during surgery. To go further, several groups have proposed augmented reality visualization, especially in the surgical microscope, to help fusing, understanding and visualizing complex medical imaging data and anatomical structures [21].…”

Registration Technology of Augmented Reality in Oral Medicine: A Review

“…The purpose of the AR is to overlay computergenerated virtual objects, scenes, or system information into real world [39]- [43]. In order to achieve a seamless overlay of virtual oral model and the patient's oral, researchers have conducted extensive research on registration technology [37], [38].…”