文献类型： 会议论文

第一作者： O. El Ganaoui

作者： O. El Ganaoui ¹ ; X. Morandi ² ; S. Duchesne ³ ; P. Jannin ⁴ ;

作者机构： 1.INRIA, VisAGeS Project-Team, F-35042 Rennes, France

2.INSERM, U746, F-35043 Rennes, France

3.University of Rennes I, CNRS, UMR 6074, IRISA, F-35042 Rennes, France

4.Hospital of Rennes, Department of Neurosurgery, F-35033 Rennes, France

关键词： neurosurgical procedures;brain shift;MIGNS;surgical workflow

会议名称： Conference on Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling; 20080217-19; San Diego,CA(US)

主办单位：

页码： i,x-

摘要： In successful brain tumor surgery, the neurosurgeon's objectives are threefold: (1) reach the target, (2) remove it and (3) preserve eloquent tissue surrounding it. Surgical Planning (SP) consists in identifying optimal access route(s) to the target based on anatomical references and constrained by functional areas. Preoperative images are essential input in Multi-modal Image Guided NeuroSurgery systems (MIGNS) and update of these images, with precision and accuracy, is crucial to approach the anatomical reality in the Operating Room (OR). Intraoperative brain deformation has been previously identified by many research groups and related update of preoperative images has also been studied. We present a study of three surgical cases with tumors accompanied with edema and where corticosteroids were administered and monitored during a preoperative stage [t_0,t_1 = t_0 + 10 days]. In each case we observed a significant change in the Region Of Interest (ROI) and in anatomical references around it. This preoperative brain shift could induce error for localization during intervention (time t_s) if the SP is based on the t_0 preoperative images. We computed volume variation, distance maps based on closest point (CP) for different components of the ROI, and displacement of center of mass (CM) of the ROI. The matching between sets of homologous landmarks from t_0 to t_1 was performed by an expert. The estimation of the landmarks displacement showed significant deformations around the ROI (landmarks shifted with mean of 3.90 ± 0.92 mm and maximum of 5.45 mm for one case resection). The CM of the ROI moved about 6.92 mm for one biopsy. Accordingly, there was a sizable difference between SP based at t_0 vs SP based at t_1, up to 7.95 mm for localization of reference access in one resection case. When compared to the typical MIGNS system accuracy (2 mm), it is recommended that preoperative images be updated within the interval time [ti,ts[ in order to minimize the error correspondence between the anatomical reality and the preoperative data. This should help maximize the accuracy of registration between the preoperative images and the patient in the OR.

分类号： [ "R312" , "R312"]