[show abstract][hide abstract] ABSTRACT: In this article a comprehensive set of registration methods is utilized to provide image-to-physical space registration for image-guided neurosurgery in a clinical study. Central to all methods is the use of textured point clouds as provided by laser range scanning technology. The objective is to perform a systematic comparison of registration methods that include both extracranial (skin marker point-based registration (PBR), and face-based surface registration) and intracranial methods (feature PBR, cortical vessel-contour registration, a combined geometry/intensity surface registration method, and a constrained form of that method to improve robustness). The platform facilitates the selection of discrete soft-tissue landmarks that appear on the patient's intraoperative cortical surface and the preoperative gadolinium-enhanced magnetic resonance (MR) image volume, i.e., true corresponding novel targets. In an 11 patient study, data were taken to allow statistical comparison among registration methods within the context of registration error. The results indicate that intraoperative face-based surface registration is statistically equivalent to traditional skin marker registration. The four intracranial registration methods were investigated and the results demonstrated a target registration error of 1.6 +/- 0.5 mm, 1.7 +/- 0.5 mm, 3.9 +/- 3.4 mm, and 2.0 +/- 0.9 mm, for feature PBR, cortical vessel-contour registration, unconstrained geometric/intensity registration, and constrained geometric/intensity registration, respectively. When analyzing the results on a per case basis, the constrained geometric/intensity registration performed best, followed by feature PBR, and finally cortical vessel-contour registration. Interestingly, the best target registration errors are similar to targeting errors reported using bone-implanted markers within the context of rigid targets. The experience in this study as with others is that brain shift can compromise extracranial registration methods from the earliest stages. Based on the results reported here, organ-based approaches to registration would improve this, especially for shallow lesions.
Medical Physics 05/2008; 35(4):1593-605. · 2.91 Impact Factor
[show abstract][hide abstract] ABSTRACT: In this paper, preliminary results from an image-to-physical space registration platform are presented. The current platform employs traditional and novel methods of registration which use a variety of data sources to include: traditional synthetic skin-fiducial point-based registration, surface registration based on facial contours, brain feature point-based registration, brain vessel-to-vessel registration, and a more comprehensive cortical surface registration method that utilizes both geometric and intensity information from both the image volume and physical patient. The intraoperative face and cortical surfaces were digitized using a laser range scanner (LRS) capable of producing highly resolved textured point clouds. In two in vivo cases, a series of registrations were performed using these techniques and compared within the context of a true target error. One of the advantages of using a textured point cloud data stream is that true targets among the physical cortical surface and the preoperative image volume can be identified and used to assess image-to-physical registration methods. The results suggest that iterative closest point (ICP) method for intraoperative face surface registration is equivalent to point-based registration (PBR) method of skin fiducial markers. With regard to the initial image and physical space registration, for patient 1, mean target registration error (TRE) were 3.1±0.4 mm and 3.6 ±0.9 mm for face ICP and skin fiducial PBR, respectively. For patient 2, the mean TRE were 5.7 ±1.3 mm, and 6.6 ±0.9 mm for face ICP and skin fiducial PBR, respectively. With regard to intraoperative cortical surface registration, SurfaceMI outperformed feature based PBR and vessel ICP with 1.7±1.8 mm for patient 1. For patient 2, the best result was achieved by using vessel ICP with 1.9±0.5 mm.
[show abstract][hide abstract] ABSTRACT: Often within the clinical environment of a neurosurgical brain tumor procedure, the surgeon is faced with the difficulty of orienting the patient's head to maximize the success of removing the pathology. Currently, these decisions are based on the experience of the surgeon. The primary objective of this paper is to demonstrate how a mathematical model can be used to evaluate the different patient positioning for tumor resection therapies. Specifically, therapies involving gravity-induced shift are used to demonstrate how a series of candidate approaches to the tumor can result in significantly different deformation behavior of brain tissue. To quantitatively assess the advantages and disadvantages of potential approaches, three different midline tumor locations were used to evaluate for the extent of tumor exposure and the magnitude of tensile stress at the brain-tumor interface, both of which are reliable indicators of the ease of resection. Preliminary results indicate that the lateral decubitus position is best suited for midline tumors.
SPIE Medical Imaging 2007: Visualization, and Image-guided ProceduresSPIE Medical Imaging 2007: Visualization, and Image-guided Procedures; 01/2007