All image-guided neurosurgical systems that we are aware of assume that the head and its contents behave as a rigid body. It is important to measure intraoperative brain deformation (brain shift) to provide some indication of the application accuracy of image-guided surgical systems, and also to provide data to develop and validate nonrigid registration algorithms to correct for such deformation. We are collecting data from patients undergoing neurosurgery in a high-field (1.5 T) interventional magnetic resonance (MR) scanner. High-contrast and high-resolution gradient-echo MR image volumes are collected immediately prior to surgery, during surgery, and at the end of surgery, with the patient intubated and lying on the operating table in the operative position. In this paper we report initial results from six patients: one freehand biopsy, one stereotactic functional procedure, and four resections. We investigate intraoperative brain deformation by examining threshold boundary overlays and difference images and by measuring ventricular volume. We also present preliminary results obtained using a nonrigid registration algorithm to quantify deformation. We found that some cases had much greater deformation than others, and also that, regardless of the procedure, there was very little deformation of the midline, the tentorium, the hemisphere contralateral to the procedure, and ipsilateral structures except those that are within 1 cm of the lesion or are gravitationally above the surgical site.
Bibliographical noteFunding Information:
Manuscript received March 31, 1998; revised June 23, 1998. The work of C. R. Maurer, Jr. was supported by the European Applications for Surgical Interventions (EASI) project, by the European Commission under Contract HC1012 in their “4th Framework Telematics Applications for Health” RTD program. The work of D. Rueckert was supported by EPSRC Project GR/L08519. The work of D. Lloret was supported in part by CICYT Projects TIC97-1 134-C02-02, TAP96-0629-C04-03, and CIRIT Project 1997BEAI200246. The Associate Editor responsible for coordinating the review of this paper and recommending its publication was M. Viergever. Asterisk indicates corresponding author.
- Brain deformation
- Brain shift
- Image-guided surgery
- Intraoperative imaging