Visualization and navigation system development and application for stereotactic deep-brain neurosurgeries

Figures & data

Figure 1. The primary graphical user interface of the system displays the 3D image volume and 2D slices of a patient (top) and those of the standard brain template (bottom). The digitized atlas is registered and fused with each image. A T2-weighted image fused with the patient image is also shown. The control panel shows the tip locations for the five probes. [Color version available online.]

Figure 2. The magnified version of Figure 1. The purple line in the center represents the central electrodes. The cyan lines parallel to the central line represent surgical trajectories. The small yellow spheres represent micro-recording data, the larger cyan spheres micro-stimulation data, and the still larger white spheres macro-stimulation data. The mesh object is the sub-thalamic nucleus (STN); the segmented STN and electrophysiological data are non-rigidly registered from the standard brain space to the patient brain image. [Color version available online.]

Table I.  Absolute differences between database-initialized and real surgical targets.

	Pallidotomy				Thalamotomy				Thalamic DBS				STN DBS
Difference	x	y	z	dis	x	y	z	dis	x	y	z	dis	x	y	z	dis
Mean (mm)	1.31	1.10	1.42	2.33	1.37	1.09	1.44	2.18	1.19	1.30	1.35	2.29	1.25	1.27	1.14	2.21
Max (mm)	2.33	2.41	2.75	3.96	2.17	2.77	2.52	3.65	2.20	2.48	2.14	3.55	2.19	2.68	2.38	3.72
Min (mm)	0.57	0.77	0.61	1.52	0.65	0.48	0.75	1.21	0.41	0.52	0.50	1.26	0.63	0.79	0.33	1.48
Std (mm)	0.62	0.68	0.67	0.80	0.51	0.78	0.69	0.77	0.60	0.71	0.68	0.71	0.53	0.61	0.74	0.73

Figure 3. Segmented sub-thalamic nucleus (STN) registered with AtamaiWarp. The mesh object is the STN. The yellow sphere is the centroid of the STN, the red sphere is the actual surgical target, and the white spheres represent surgical targets of previous patients. The color-coded map is the probability map of a collection of left STN DBS targets. [Color version available online.]

Table II.  Absolute differences between centroids of segmented nuclei after non-rigid registration and real surgical targets.

	Pallidotomy				Thalamotomy/thalamic DBS				STN DBS
Difference	x	y	z	dis	x	y	z	dis	x	y	z	dis
Mean (mm)	1.55	1.60	1.18	2.53	1.16	1.13	1.35	2.24	1.36	1.88	0.85	2.80
Max (mm)	2.43	2.45	1.76	3.17	1.99	2.38	1.86	3.09	2.32	3.23	1.45	3.57
Min (mm)	0.22	0.51	0.30	0.97	0.18	0.36	0.40	1.05	0.31	0.01	0.23	1.21
Std (mm)	0.61	0.93	0.77	0.83	0.69	0.97	0.72	0.79	0.74	1.15	0.60	0.87

Table III.  Absolute differences between non-expert-estimated and real surgical targets.

	Pallidotomy				Thalamotomy				Thalamic DBS				STN DBS
Difference	x	y	z	dis	x	y	z	dis	x	y	z	dis	x	y	z	dis
Mean (mm)	0.61	0.65	0.87	1.83	0.48	0.73	0.75	1.95	0.43	0.70	0.74	1.88	0.55	0.68	0.70	1.61
Max (mm)	1.42	1.33	1.34	2.79	1.29	1.30	1.51	2.69	1.22	1.26	1.38	2.41	1.31	1.43	1.39	2.82
Min (mm)	0.10	0.27	0.33	0.58	0.23	0.28	0.35	0.62	0.17	0.12	0.35	0.54	0.06	0.30	0.2	0.65
Std (mm)	0.49	0.39	0.31	1.07	0.51	0.38	0.40	0.86	0.48	0.40	0.32	0.89	0.50	0.38	0.35	0.67