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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Automatic updating of neuronavigation with intraoperative high-field MR image data

Automatischer Update der Neuronavigation mit intraoperativen Hochfeld-MR Daten

Meeting Abstract

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  • corresponding author Christopher Nimsky - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Erlangen
  • O. Ganslandt - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Erlangen
  • Keller B. v. - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Erlangen
  • R. Fahlbusch - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Erlangen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.06.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0063.shtml

Published: April 23, 2004

© 2004 Nimsky et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To establish a neuronavigation update procedure based on intraoperative high-field magnetic resonance imaging (MRI).

Methods

A 1.5T Magnetom Sonata (Siemens Medical Solutions, Erlangen, Germany) in combination with a NC4-Multivision microscope (Zeiss, Oberkochen, Germany) and a ceiling mounted navigation system VectorVisionSky (BrainLAB, Heimstetten, Germany) enables microscope-based neuronavigation with intraoperative high-field MRI. Pre- and intraoperative image data are registered by a semi-automatic rigid registration applying an intensity based pyramidal approach using mutual information (ImageFusion software, BrainLAB). The registered images are then transferred to the navigation system without altering the initial patient registration file, updating neuronavigation.

Results

Between April 2002 and mid-November 2003 258 patients underwent intraoperative high-field MRI. In 102 of the 123 craniotomy cases microscope-based neuronavigation was applied, in 39 with integrated functional data. In 31.4% (32/102) intraoperative imaging revealed some remaining tumor that could be further resected. The remaining tumor was segmented and the navigation system was updated with intraoperative image data by restoring the initial registration file. Landmark checks proved ongoing clinical application accuracy. No intraoperative patient re-registration was necessary, improving surgical workflow. The tumor remnants could be localized reliably in all cases. Registered pre- and intraoperative images could be navigated simultaneously, improving the interpretation of intraoperative image changes.

Conclusions

Updating of neuronavigation systems with intraoperative image data is possible without repeated patient registration. Tumor remnants depicted by intraoperative imaging can be localized reliably, and brain shift can also be compensated for.