Novel Risk Assessment Methodology for Keyhole Neurosurgery with Genetic Algorithm for Trajectory Planning

Abstract

Keyhole neurosurgery implies reaching a target area inside the brain through an entry point specified by the neurosurgeon. In order to avoid complications, a risk assessment procedure must be done to establish the minimum risk trajectory from the entry point to the target area. The neurosurgeon establishes the risk values for the brain structure according to the type of intervention. The preset brain structure risk value is used to assess the risk value for each voxel of the brain. This paper proposes an improved risk assessment methodology based on the sum of N maximum risk values for each voxel. Then, risk assessment for a trajectory is done by adding the risk of all voxels that are part of the path. The safest trajectory is defined as the trajectory with the lower risk. Our proposed search trajectory methodology includes a Genetic Algorithm (GA) for finding the safest trajectories. The use of a GA drastically reduces the number of trajectories to analyze, speeding up the planning procedure. The achieved results were qualified by expert neurosurgeons as satisfactory. Our proposed method allows neurosurgeons to calibrate the surgical planning system by allowing them to establish the risk brain structure and the risk value for each structure.