Predicted microscopic cortical brain images for optimal craniotomy positioning and visualisation

ABSTRACT

During a craniotomy, the skull is opened to allow surgeons to have access to the brain and perform the procedure. The position and size of this opening are chosen in a way to avoid critical structures, such as vessels, and facilitate the access to tumours. Planning the operation is done based on pre-operative images and does not account for intra-operative surgical events. We present a novel image-guided neurosurgical system to optimise the craniotomy opening. Using physics-based modelling we define a cortical deformation map that estimates the displacement field at candidate craniotomy locations. This deformation map is coupled with an image analogy algorithm that produces realistic synthetic images that can be used to predict both the geometry and the appearance of the brain surface before opening the skull. These images account for cortical vessel deformations that may occur after opening the skull and is rendered in a way that increases the surgeon’s understanding and assimilation. Our method was tested retrospectively on patients data showing good results and demonstrating the feasibility of practical use of our system.

KEYWORDS:

• Image-guided neurosurgery
• physics-based simulation
• image analogy
• computer-aided interventions
• visualisation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Brigham and Women’s Hospital [Research Pilot grant]; NIH [R01 EB027134-01,R01 NS049251].

Notes on contributors

Nazim Haouchine

Nazim Haouchine is a Postdoctoral Research Fellow at Harvard Medical School and Brigham and Women's Hospital with the Surgical Planning Lab.

Parikshit Juvekar

Parikshit Juvekar is a Postdoctoral Research Fellow in the Department of Neurosurgery at Brigham & Women's Hospital and Harvard Medical School.

Alexandra Golby

Alexandra Golby is Professor of Neurosurgery and Professor of Radiology at Harvard Medical School.

Sarah Frisken

Sarah Frisken, Ph. D., is Assistant Professor in Radiology at Harvard Medical School and Brigham and Women's Hospital.