American Journal of Neuroradiology
BACKGROUND AND PURPOSE: Intraoperative brain deformation is an important factor compromising the accuracy of image-guided neurosurgery. The purpose of this study was to elucidate the role of a model-updated image in the compensation of intraoperative brain shift. MATERIALS AND METHODS: An FE linear elastic model was built and evaluated in 11 patients with craniotomies. To build this model, we provided a novel model-guided segmentation algorithm. After craniotomy, the sparse intraoperative data (the deformed cortical surface) were tracked by a 3D LRS. The surface deformation, calculated by an extended RPM algorithm, was applied on the FE model as a boundary condition to estimate the entire brain shift. The compensation accuracy of this model was validated by the real-time image data of brain deformation acquired by intraoperative MR imaging. RESULTS: The prediction error of this model ranged from 1.29 to 1.91 mm (mean, 1.62 +/- 0.22 mm), and the compensation accuracy ranged from 62.8% to 81.4% (mean, 69.2 +/- 5.3%). The compensation accuracy on the displacement of subcortical structures was higher than that of deep structures (71.3 +/- 6.1%; 66.8 +/- 5.0%, P < .01). In addition, the compensation accuracy in the group with a horizontal bone window was higher than that in the group with a nonhorizontal bone window (72.0 +/- 5.3%; 65.7 +/- 2.9%, P < .05). CONCLUSIONS: Combined with our novel model-guided segmentation and extended RPM algorithms, this sparse data-driven biomechanical model is expected to be a reliable, efficient, and convenient approach for compensation of intraoperative brain shift in image-guided surgery.
Zhuang, D. X., Liu, Y. X., Wu, J. S., Yao, C. J., Mao, Y., Zhang, C. X., ... & Zhou, L. F. (2011). A sparse intraoperative data-driven biomechanical model to compensate for brain shift during neuronavigation. American Journal of Neuroradiology, 32(2), 395-402.