Artikel
Intraoperative image updating with an one-platform pre-calibrated image-guided-ultrasound system
Intraoperative Bilderneuerung der Neuronavigation durch integrierten präkalibierten Ultraschall
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
The integration of ultrasound technology into neuronavigation systems has recently been reported. This study describes our findings with regard to the integration of an ultrasound probe that is completely integrated in an existing navigation platform. It was the aim of our study to investigate (1) whether the system might simplify neurosurgical interventions and (2) for which indications it might be used.
Methods
The ultrasound system consists of a phased array ultrasound transducer and a small external electronic module with a connection length of 2.8m to the probe. The probe has a frequency range from 5.0 to 7.5MHz, a penetration depth up to 120mm using 128 channels at a footprint of 15mm x 25mm of the scanning area (IGsonic, BrainLAB, Germany). The ultrasound system is integrated into the neuronavigation system (VectorVision2, BrainLAB, Germany) via digital image transmission and electronic parameter control by the navigation software (VV Cranial). A precalibrated tracking array is attached to the probe and allows to track the position of the ultrasound image plane. The system was used for 26 patients with variable intracerebral pathologies.
Results
The system worked properly during 26 procedures with various surgeons. A number of intracranial pathologies was visualized, including 8 subcortical cavernomas, 7 high grade gliomas, 7 low grade gliomas, 2 meningiomas, 1 metastasis, and 1 dAVF, respectively. It displays a combination of the ultrasound plane functionality with the preoperatively-acquired neuronavigational data and provides intraoperative image updating. Furthermore, color mode information on the vascular anatomy can be added to the navigation data set.
Conclusions
The image-guided ultrasound in this one-platform system worked without technical pitfalls. In contrast to the previous technology (two platform solution) it was used even by physicians that were not related to its development. Its touch screen technology helps to save manpower because the surgeon uses the system sterile without assistance. The system offers a color-mode guided integration of vascular anatomy into the neuronavigational dataset. Ultrasound helps to display the most common intracerebral pathologies and therefore offers intraoperative image updating with a certain information on brain shift. So far, however, no (3D-) elastic fusion of the preoperative images and the intraoperative ultrasound data set is available, so that brain shift can be fully corrected.