Mapping Resection Progress by Tool-Tip Tracking during Brain Tumor Surgery for Real-Time Estimation of Residual Tumor.
Mapping Resection Progress by Tool-Tip Tracking during Brain Tumor Surgery for Real-Time Estimation of Residual Tumor.
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外科切除术仍然是神经外科肿瘤学的主要治疗策略。基于术前成像的计算机化颅神经量化可以在早期肿瘤切除期间提供精确的指导，但随着过程的去除和移动而失去有效性。术中MRI（IMRI）和术中超声（IUS）等模态可以恢复图像指导以最大程度地提高切除程度，但分别在时间和空间分辨率方面提出了挑战。我们的研究利用临床神经驱动系统的未开发的数据流来跟踪手术仪器的时间stamp刀尖位置。这使切除术的映射具有时间和空间精度，以实时估计残留肿瘤。就其本身而言，我们的技术可以作为世界上资源有限地区的IMRI的替代方法，也可以作为一种教育培训和评估工具。它也可以与其他术中成像方式（例如IUS）结合使用，以更准确地建模并补偿大脑转移。
手术切除术仍然是治疗脑肿瘤患者的主要初始治疗策略。基于术前成像的计算机化颅神经量化在颅骨切开术和早期肿瘤切除期间提供了精确的指导，但逐渐失去了随着脑移位的有效性。术中MRI（IMRI）和术中超声（IUS）可以更新用于指导和导航的成像，但分别在时间和空间分辨率方面受到限制。我们提出了一个系统，该系统使用手术仪器的时间stamp的工具尖端位置以高空间和时间精度生成切除进度的地图。我们评估了该系统，并提出了80个颅肿瘤切除术的结果。切除图（真正的阳性跟踪）涵盖的术前肿瘤分割的区域和术前肿瘤分割的区域未涵盖切除图（真正的阴性跟踪）。我们比较了真正的负面跟踪，该跟踪估计残留肿瘤，与使用IMRI鉴定的实际残留肿瘤。我们讨论可能导致假阳性跟踪和假阴性跟踪的因素，这些因素分别低估并高估了残留肿瘤。当大脑移位最小并保持视线时，我们的方法可以很好地估计残留肿瘤。当不满足这些情况时，外科医生报告说，它仍然可用于识别潜在残留区域。
Surgical resection continues to be the primary therapeutic strategy in neurosurgical oncology. Computerized cranial neuronavigation based on preoperative imaging can offer precision guidance during early tumor resection but loses validity as the procedure progresses with tissue removal and shifting. Modalities such as intraoperative MRI (iMRI) and intraoperative ultrasound (iUS) can restore image guidance to maximize the extent of resection but present challenges in terms of temporal and spatial resolution, respectively. Our study leverages an untapped data stream from clinical neuronavigation systems to track time-stamped tool-tip positions of surgical instruments. This enables the mapping of resection progress with temporal and spatial accuracy for the real-time estimation of residual tumors. By itself, our technique could serve as an alternative to iMRI for resource-limited regions of the world and as an educational training and evaluation tool. It could also be combined with other intraoperative imaging modalities, such as iUS, to more accurately model and compensate for brain shift. Surgical resection continues to be the primary initial therapeutic strategy in the treatment of patients with brain tumors. Computerized cranial neuronavigation based on preoperative imaging offers precision guidance during craniotomy and early tumor resection but progressively loses validity with brain shift. Intraoperative MRI (iMRI) and intraoperative ultrasound (iUS) can update the imaging used for guidance and navigation but are limited in terms of temporal and spatial resolution, respectively. We present a system that uses time-stamped tool-tip positions of surgical instruments to generate a map of resection progress with high spatial and temporal accuracy. We evaluate this system and present results from 80 cranial tumor resections. Regions of the preoperative tumor segmentation that are covered by the resection map (True Positive Tracking) and regions of the preoperative tumor segmentation not covered by the resection map (True Negative Tracking) are determined for each case. We compare True Negative Tracking, which estimates the residual tumor, with the actual residual tumor identified using iMRI. We discuss factors that can cause False Positive Tracking and False Negative Tracking, which underestimate and overestimate the residual tumor, respectively. Our method provides good estimates of the residual tumor when there is minimal brain shift, and line-of-sight is maintained. When these conditions are not met, surgeons report that it is still useful for identifying regions of potential residual.
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影响因子：
6.2
作者：
Tempany, Clare M. C.;Jayender, Jagadeesan;Kapur, Tina;Bueno, Raphael;Golby, Alexandra;Agar, Nathalie;Jolesz, Ferenc A.
通讯作者：
Jolesz, Ferenc A.
影响因子：
4.8
作者：
Nimsky, C;Ganslandt, O;Fahlbusch, R
通讯作者：
Fahlbusch, R
DOI：
10.1007/s11548-022-02644-w
发表时间：
2022-05-05
影响因子：
3
作者：
Leger, Etienne;Horvath, Samantha;Golby, Alexandra
通讯作者：
Golby, Alexandra
DOI：
10.1109/tbme.2014.2322864
发表时间：
2014-10
期刊：
IEEE transactions on bio-medical engineering
影响因子：
--
作者：
Lasso A;Heffter T;Rankin A;Pinter C;Ungi T;Fichtinger G
通讯作者：
Fichtinger G
影响因子：
4.7
作者：
Mosteiro, Alejandra;Di Somma, Alberto;Roldan Ramos, Pedro;Ferres, Abel;De Rosa, Andrea;Gonzalez-Ortiz, Sofia;Ensenat, Joaquim;Juan Gonzalez, Jose
通讯作者：
Juan Gonzalez, Jose