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Integrated multi-modality image-guided navigation for neurosurgery: open-source software platform using state-of-the-art clinical hardware
International Journal of Computer Assisted Radiology and Surgery ( IF 3 ) Pub Date : 2021-05-03 , DOI: 10.1007/s11548-021-02374-5
Jonathan Shapey 1, 2, 3 , Thomas Dowrick 2, 4, 5 , Rémi Delaunay 2 , Eleanor C Mackle 2 , Stephen Thompson 2, 4, 5 , Mirek Janatka 2, 4, 5 , Roland Guichard 6 , Anastasis Georgoulas 6 , David Pérez-Suárez 6 , Robert Bradford 3 , Shakeel R Saeed 3, 7, 8 , Sébastien Ourselin 1 , Matthew J Clarkson 2, 4, 5 , Tom Vercauteren 1
Affiliation  

Purpose

Image-guided surgery (IGS) is an integral part of modern neuro-oncology surgery. Navigated ultrasound provides the surgeon with reconstructed views of ultrasound data, but no commercial system presently permits its integration with other essential non-imaging-based intraoperative monitoring modalities such as intraoperative neuromonitoring. Such a system would be particularly useful in skull base neurosurgery.

Methods

We established functional and technical requirements of an integrated multi-modality IGS system tailored for skull base surgery with the ability to incorporate: (1) preoperative MRI data and associated 3D volume reconstructions, (2) real-time intraoperative neurophysiological data and (3) live reconstructed 3D ultrasound. We created an open-source software platform to integrate with readily available commercial hardware. We tested the accuracy of the system’s ultrasound navigation and reconstruction using a polyvinyl alcohol phantom model and simulated the use of the complete navigation system in a clinical operating room using a patient-specific phantom model.

Results

Experimental validation of the system’s navigated ultrasound component demonstrated accuracy of \(<4.5\,\hbox {mm}\) and a frame rate of 25 frames per second. Clinical simulation confirmed that system assembly was straightforward, could be achieved in a clinically acceptable time of \(<15\,\hbox {min}\) and performed with a clinically acceptable level of accuracy.

Conclusion

We present an integrated open-source research platform for multi-modality IGS. The present prototype system was tailored for neurosurgery and met all minimum design requirements focused on skull base surgery. Future work aims to optimise the system further by addressing the remaining target requirements.



中文翻译:

用于神经外科的集成多模态图像引导导航:使用最先进临床硬件的开源软件平台

目的

影像引导手术 (IGS) 是现代神经肿瘤外科手术不可或缺的一部分。导航超声为外科医生提供了超声数据的重建视图,但目前没有商业系统允许将其与其他基本的非基于成像的术中监测方式集成,例如术中神经监测。这样的系统在颅底神经外科手术中特别有用。

方法

我们确定了为颅底手术量身定制的集成多模态 IGS 系统的功能和技术要求,该系统能够整合:(1) 术前 MRI 数据和相关的 3D 体积重建,(2) 实时术中神经生理学数据和 (3)实时重建的 3D 超声。我们创建了一个开源软件平台,以与现成的商业硬件集成。我们使用聚乙烯醇体模模型测试了系统超声导航和重建的准确性,并使用患者特定体模模型在临床手术室模拟了完整导航系统的使用。

结果

系统导航超声组件的实验验证证明了\(<4.5\,\hbox {mm}\)的准确性和每秒 25 帧的帧速率。临床模拟证实,系统组装很简单,可以在临床可接受的\(<15\,\hbox {min}\)时间内实现,并以临床可接受的准确度水平进行。

结论

我们为多模态 IGS 提供了一个集成的开源研究平台。目前的原型系统是为神经外科量身定制的,并满足所有以颅底手术为重点的最低设计要求。未来的工作旨在通过解决剩余的目标要求来进一步优化系统。

更新日期:2021-05-03
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