Estimation of Intraoperative Brain Deformation
Estimation of Intraoperative Brain Deformation
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术中脑变形的估计
DOI：
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
K. Paulsen
中科院分区：
文献类型：
--
作者：
Songbai Ji;Xiaoyao Fan;A. Hartov;D. Roberts;K. Paulsen
基于术前图像的图像引导神经导航已成为许多开放性颅脑手术的标准治疗。手术室中的感兴趣结构与术前图像之间的患者配准的准确性对于图像引导的有效部署至关重要。脑移位被广泛认为是降低手术期间配准精度的最重要因素。术中成像技术对于补偿脑移位很重要。然而，由于高资本成本和对手术工作流程的干扰（例如，术中磁共振）或不足以提供用于神经导航的全场图像数据（例如，术中超声、立体视觉和激光范围扫描）。或者，生物力学模型对于术中估计脑变形变得越来越有吸引力，因为它们提供全脑位移场，从该位移场生成模型更新的MR图像用于随后的引导，并且成本低。因为从术中图像导出的实质特征位移可以被并入模型计算中，所以在患者特定的基础上估计脑变形，并且可以允许在整个手术期间保持图像到患者配准的足够准确性。显然，该技术在OR中应用的临床可行性取决于建模更新的性能以及术中图像的特征位移生成。本章详细介绍了用于估计术中全脑变形以产生更新的MR图像体积的计算方案的重要方面。还描述了使用术中荧光成像验证模型估计的初步结果。
Image-guided neuronavigation based on preoperative images has become the standard-of-care in many open cranial surgeries. The accuracy of patient registration between structures of interest in the operating room and preoperative images is essential for effective deployment of image-guidance. Brain shift is widely recognized as the single most important factor that degrades registration accuracy during surgery. Intraoperative imaging techniques are important to compensate for brain shift. However, they alone are either impractical for broad clinical acceptance due to high capital cost and intrusion on surgical workflow (e.g., intraoperative magnetic resonance) or insufficient to provide full-field image data for neuronavigation (e.g., intraoperative ultrasound, stereovision, and laser range scanning). Alternatively, biomechanical models are becoming increasingly attractive for estimating brain deformation intraoperatively because they offer whole-brain displacement fields from which to generate model-updated MR images for subsequent guidance, and are low in cost. Because parenchymal feature displacements derived from intraoperative images can be incorporated into model computation, brain deformation is estimated on a patient-specific basis and may allow sufficient accuracy in image-to-patient registration to be maintained throughout surgery. Apparently, the clinical feasibility of this technique for application in the OR depends on the performance of the modeling updates as well as the generation of feature displacements from intraoperative images. This chapter presents details on the important aspects of a computational scheme for estimating intraoperative whole-brain deformation to produce an updated MR image volume. Preliminary results using intraoperative fluorescence imaging for validation of model estimation are also described.
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