Assessment of Improved Navigation for Pediatric Brain Tumor Surgery

小儿脑肿瘤手术改进导航的评估

• 批准号: 7346817
• 负责人: SIMON K WARFIELD
• 金额: $ 38.03万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7346817
• 关键词: Adult; Algorithms; Area; Boston; Brain; Brain Neoplasms; Case-Control Studies; Characteristics; Childhood Brain Neoplasm; Clinical; Computational Science; Corticospinal Tracts; Data; Decision Making; Diffusion Magnetic Resonance Imaging; Excision; Fiber; Functional Magnetic Resonance Imaging; Funding; Hand; Image; Imagery; Lead; Literature; Location; Magnetic Resonance Imaging; Measurement; Measures; Methods; Modality; Monitor; Motor Cortex; NIH Program Announcements; Navigation System; Neurologic; Neurological outcome; Neurosurgeon; Operating Rooms; Operative Surgical Procedures; Outcome; Patients; Pediatric Hospitals; Peer Review; Performance; Positioning Attribute; Postoperative Period; Procedures; Psyche structure; Public Health; Publishing; Research; Research Design; Research Personnel; Research Proposals; Resected; Residual Tumors; Resolution; Review Literature; Shapes; Site; Statistically Significant; Structure; Surgeon; Surgical Instruments; Surrogate Markers; System; Techniques; Technology; Testing; Time; Tissues; Tumor Volume; Ultrasonography; Work; brain surgery; critical developmental period; design; gray matter; image visualization; improved; innovation; intraoperative imaging; neurosurgery; novel; prevent; programs; response; soft tissue; success; technology development; tumor; white matter

DESCRIPTION (provided by applicant):. This research proposal is a new R01 application in response to the Program Announcement "Innovations in Biomedical Computational Science and Technology" for five years of funding to apply and evaluate novel surgical navigation technology to improve outcomes in pediatric brain tumor surgery. Commercially available surgical navigation systems can align multi-modality data at the start of surgery, and provide real-time tracking of surgical instruments. However, existing systems are unable to align data following soft tissue deformation such as occurs during resection of pediatric brain tumors. As a consequence, the precise alignment established at the start of surgery is lost, and the accuracy of preoperative to intraoperative data fusion is progressively worsened as the neurosurgery continues. At the critical periods of final resection of the tumor margin, the accuracy of alignment is worst, and the preoperative data does not provide a direct guide to the neurosurgeon. It is our objective to significantly increasing the amount of time during the surgery for which precisely aligned fused visualization of preoperative and intraoperative data will be available to the neurosurgeon. We will apply a novel nonrigid registration algorithm that we have recently developed for intraoperative data fusion, as well as the best available techniques published by other groups, in order to re-establish precise navigation with preoperative data. We will assess the efficacy of the enhanced navigation by assessing the volume and percentage of tumor resected, and by assessing neurological outcomes following the surgery. The specific aims of this research are to 1) Evaluate target registration error of nonrigid registration algorithms for pediatric brain tumor surgery, 2) Significantly improve the duration of precise alignment and data fusion during pediatric brain tumor surgery, and to 3) Evaluate the efficacy of enhanced navigation by assessing post-operative tumor resection volume. This proposal will benefit public health by evaluating key technologies to enable enhanced intraoperative navigation during pediatric brain tumor surgery. The capacity to visualize the tumor and tumor margin throughout the surgery, together with functionally significant cortical gray matter regions and white matter fiber tracts, will better enable the neurosurgeon to achieve more complete tumor resection without creating neurological deficits. The assessment of surgical resection will lead to a quantitative determination of the efficacy of enhanced navigation during pediatric brain tumor surgery.

描述（由申请人提供）：该研究提案是一项新的R 01申请，以响应项目公告“生物医学计算科学与技术创新”，该项目为期五年，旨在应用和评估新型手术导航技术，以改善儿科脑肿瘤手术的结局。市售的手术导航系统可以在手术开始时对齐多模态数据，并提供手术器械的实时跟踪。然而，现有的系统不能在软组织变形（诸如在儿科脑肿瘤的切除期间发生的软组织变形）之后对准数据。因此，在手术开始时建立的精确对准丢失，并且随着神经外科手术的继续，术前到术中数据融合的准确性逐渐恶化。在最后切除肿瘤边缘的关键时期，对线的准确性最差，术前数据不能为神经外科医生提供直接指导。 我们的目标是显著增加手术期间的时间量，在此期间，神经外科医生将可获得术前和术中数据的精确对准融合可视化。我们将应用一种新的非刚性配准算法，我们最近开发的术中数据融合，以及其他团体发表的最佳技术，以重建术前数据的精确导航。我们将通过评估切除肿瘤的体积和百分比以及评估手术后的神经功能结局来评估增强导航的有效性。 本研究的具体目的是：1）评价儿科脑肿瘤手术中非刚性配准算法的靶点配准误差; 2）显著改善儿科脑肿瘤手术中精确对准和数据融合的持续时间; 3）通过评估术后肿瘤切除体积评价增强导航的有效性。 该提案将通过评估关键技术使儿科脑肿瘤手术期间增强术中导航受益于公共卫生。在整个手术过程中可视化肿瘤和肿瘤边缘的能力，以及功能显著的皮质灰质区域和白色物质纤维束，将使神经外科医生能够更好地实现更完整的肿瘤切除而不会产生神经功能缺损。手术切除的评估将导致定量确定儿科脑肿瘤手术期间增强导航的有效性。