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

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Each year, thousands of Canadians undergo neurosurgery for resection of brain lesions suchas tumours, epileptic foci and vascular malformations that are in close proximity to areas ofthe brain that are critical to movement, vision, sensation, or language. Accurate guidanceinformation is required to balance two constraints: achieving maximal resection ofpathological tissue while minimizing potential neurological deficits. Image-guidedneurosurgery systems (i.e., a GPS for surgery) provide tools to visualize and interpret patientspecificvolumes of anatomical, vascular and functional data to enable precise surgicalinterventions. Unfortunately, brain tissue can deform up to 30mm or more during surgery(known as brain shift). Over the past 15 years, Collins' NeuroImaging and SurgicalTechnologies (NIST) lab at the MNI has developed an open-source research image-guidedsurgery 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, andanatomical coverage.We propose to integrate data from multiple sensors and multiple algorithms to accurately androbustly account for brain shift and allow for accurate guidance throughout surgery. To dothis we will apply Kalman filters in a multi-channel registration framework. To reducedevelopment costs and facilitate inter-lab collaborations, we will integrate our IBIS softwareinto 3DSlicer to take advantage of a huge user base (280,000 downloads, 250+/week). Ourindustrial partner Synaptive Medical, a dynamic Toronto-based startup, will provide input,ensure commercial relevance and help trainees learn about development andcommercialization of medical devices. Synaptive's help will facilitate translation of our imageguidedtechnology to the operating room so that all patients can benefit from these tools.