gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Cinematic rendering – a novel approach for preoperative photorealistic visualisation of intracranial aneurysms and vascular anatomy

Cinematic rendering – ein neuer Ansatz für die präoperative photorealistische Darstellung von intrakraniellen Aneurysmen und der Gefäßanatomie

Meeting Abstract

  • presenting/speaker Amr Abdulazim - Universitätsmedizin Mannheim, Universität Heidelberg, Klinik für Neurochirurgie, Mannheim, Deutschland
  • Daniel Overhoff - Universitätsmedizin Mannheim, Universität Heidelberg, Institut für klinische Radiologie und Nuklearmedizin, Mannheim, Deutschland
  • Katharina Hackenberg - Universitätsmedizin Mannheim, Universität Heidelberg, Klinik für Neurochirurgie, Mannheim, Deutschland
  • Holger Haubenreisser - Universitätsmedizin Mannheim, Universität Heidelberg, Institut für klinische Radiologie und Nuklearmedizin, Mannheim, Deutschland
  • Daniel Hänggi - Universitätsmedizin Mannheim, Universität Heidelberg, Klinik für Neurochirurgie, Mannheim, Deutschland
  • Nima Etminan - Universitätsmedizin Mannheim, Universität Heidelberg, Klinik für Neurochirurgie, Mannheim, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV115

doi: 10.3205/19dgnc121, urn:nbn:de:0183-19dgnc1210

Veröffentlicht: 8. Mai 2019

© 2019 Abdulazim et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The two most widely used CT postprocessing 3D tools in clinical practice are maximum intensity projections (MIP) and volume rendering (VR). Recently, the VR technique has been enhanced by the incorporation of a new lighting model, using global illumination, which takes direct and indirect illumination into account when construcitng an image, thus providing a more natural and photorealistic illumination of the rendered data. Here, we investigated the value of cinematic rendering (CR) in the preoperative visualization of intracranial aneurysms (IA) and the adjacent vascular anatomy for preoperative planning and training in aneurysm surgery.

Methods: A prospective cohort of 10 consecutive patients with either ruptured or unruptured IA underwent CT-angiography using either a 2nd or 3rd generation dual-source CT scanner. Classic VR as well as CR images were generated and evaluated with respect to visualization of the aneurysm (neck, morphology, projection) and its spatial relationship to the adjacent anatomy (parent vessels, skull base, interlobar fissures). This was later correlated with the intraoperative view.

Results: Compared to VR, the more realistic light emulation of cinematic rendering enhanced depth and shape perception, thus improving the visualization of intracranial aneurysms especially with respect to evaluation of the aneurysm neck and its spatial relation to parent vessels. This enabled a reliable preoperative planning and facilitated a targeted intraoperative preparation towards the aneurysm neck, especially in ruptured IA. Further, real-time manipulations of CR images allowed for a repeatable virtual layer by layer dissection from the skin to the aneurysm.

Conclusion: Our preliminary experience with CR image reconstructions emphasizes the promising value of CR to more accurately depict anatomic detail. This earns CR the potential to serve as an educational simulation tool in the training of vascular neurosurgeons by allowing a near realistic preoperative visualization of the surgical anatomy.