gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Neuronavigation guided by intraoperative 3D ultrasound

Intraoperativer Einsatz von 3D-Ultraschall in der Neuronavigation

Meeting Abstract

  • corresponding author O. Bozinov - Neurochirurgische Klinik, Universitätsklinikum Marburg
  • Y. Enchev - Neurochirurgische Klinik, Universitätsklinikum Marburg
  • S. Heinze - Neurochirurgische Klinik, Universitätsklinikum Marburg
  • D. Miller - Neurochirurgische Klinik, Universitätsklinikum Marburg
  • H. Bertalanffy - Neurochirurgische Klinik, Universitätsklinikum Marburg
  • U. Sure - Neurochirurgische Klinik, Universitätsklinikum Marburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.10.03

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Bozinov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Ultrasound is a cost effective intraoperative imaging modality used frequently. It has been used in combination with neuronavigation as an alternative to intraoperative magnetic resonance imaging (MRI). 3-D ultrasound technology can solve the orientation problem experienced previously with two-dimensional ultrasound. So-called Two-platform solutions tend to prolong operative time due to the calibration procedure. A novel operative image guided system overcomes this disadvantage and provides 3D ultrasound images.

Methods: The new ultrasound system (IGSonic) is integrated into a neuronavigation system (VectorVision2, BrainLAB, Germany). A precalibrated tracking array is attached to the probe and allows tracking the position of the ultrasound image plane. We have used intraoperative 3-D ultrasound data acquisition for four patients with brain tumours. The acquisition time was 1-2 minutes each and calculation time was 30 – 60 seconds. Acquisition was only triggered at points with no information. 256 slices were collected per data set and ultrasound data was reconstructed based on spatial resolution. 3D-ultrasound was fused to preoperative data via a registration and reference coordinate system, no coregistration was necessary.

Results: The system worked properly during all procedures. It displays a reconstruction view of 3D-ultrasound (axial, sagittal, coronal) and live ultrasound in combination with the preoperatively acquired neuronavigational data (CT or MRI). It provides intraoperative image updating for a maximum of 10 sets. Intraoperative 3-D ultrasound represents a possible solution for the problem of brain shift in neuronavigation, because it gives an instant and updated three-dimensional orientation as well as an accurate map of the patient's true anatomy at various stages of the operation.

Conclusions: 3D-ultrasound provides online information on the progress of surgery and displays the pre- or intraoperatively acquired information, such as labelled points, trajectories or objects. Intraoperative 3D-ultrasound acquisition for neuronavigation might also be used without preoperatively acquired neuronavigational data.