Achieving precision in Image-guided Neurosurgery via an open source collaborative software environment

每年，成千上万的加拿大人接受神经外科手术来切除脑部病变，如肿瘤、癫痫灶和血管畸形，这些病变靠近大脑中对运动、视觉、感觉或语言至关重要的区域。需要准确的指导**信息来平衡两个约束：最大限度地切除**病理组织，同时尽量减少潜在的神经功能缺陷。图像引导神经外科系统（即用于手术的GPS）提供了可视化和解释患者特定解剖、血管和功能数据的工具，以实现精确的手术干预。不幸的是，在手术过程中，脑组织可能会变形30毫米或更多（称为脑移位）。在过去的15年里，柯林斯在MNI的神经成像和外科技术（NIST）实验室开发了一个开源的研究图像引导手术平台，称为IBIS。我们的新贡献是使用术中获得的超声**来实现准确的患者图像配准，即使在存在脑移位的情况下。然而，我们的方法有时在准确性、稳健性和解剖学覆盖方面受到限制。**我们建议整合来自多个传感器和多种算法的数据，以准确、可靠地解释脑转移，并在整个手术过程中提供准确的指导。为了做到这一点，我们将在多通道注册框架中应用卡尔曼滤波器。为了降低**开发成本并促进实验室间的合作，我们将把IBIS软件**集成到3DSlicer中，以利用庞大的用户群（280,000次下载，250+/周）。我们的工业合作伙伴Synaptive Medical是一家充满活力的多伦多初创公司，将提供投入，确保商业相关性，并帮助学员了解医疗设备的开发和商业化。Synaptive的帮助将有助于将我们的图像引导**技术翻译到手术室，以便所有患者都能从这些工具中受益。

Each year, thousands of Canadians undergo neurosurgery for resection of brain lesions such**as tumours, epileptic foci and vascular malformations that are in close proximity to areas of**the brain that are critical to movement, vision, sensation, or language. Accurate guidance**information is required to balance two constraints: achieving maximal resection of**pathological tissue while minimizing potential neurological deficits. Image-guided**neurosurgery systems (i.e., a GPS for surgery) provide tools to visualize and interpret patientspecific**volumes of anatomical, vascular and functional data to enable precise surgical**interventions. Unfortunately, brain tissue can deform up to 30mm or more during surgery**(known as brain shift). Over the past 15 years, Collins' NeuroImaging and Surgical**Technologies (NIST) lab at the MNI has developed an open-source research image-guided**surgery platform known as IBIS. Our novel contribution uses ultrasound, acquired intraoperatively,**to achieve accurate patient-image registration, even in the presence of brain shift.**However, our methods can sometimes be limitated in terms of accuracy, robustness, and**anatomical coverage.**We propose to integrate data from multiple sensors and multiple algorithms to accurately and**robustly account for brain shift and allow for accurate guidance throughout surgery. To do**this we will apply Kalman filters in a multi-channel registration framework. To reduce**development costs and facilitate inter-lab collaborations, we will integrate our IBIS software**into 3DSlicer to take advantage of a huge user base (280,000 downloads, 250+/week). Our**industrial partner Synaptive Medical, a dynamic Toronto-based startup, will provide input,**ensure commercial relevance and help trainees learn about development and**commercialization of medical devices. Synaptive's help will facilitate translation of our imageguided**technology to the operating room so that all patients can benefit from these tools.