Abstract
In this paper, initial clinical data from an intraoperative MR system are compared to calculations made by a three-dimensional finite element model of brain deformation. The preoperative and intraoperative MR data was collected on a patient undergoing a resection of an astrocytoma, grade 3 with non-enhancing and enhancing regions. The image volumes were co-registered and cortical displacements as well as subsurface structure movements were measured retrospectively. These data were then compared to model predictions undergoing intraoperative conditions of gravity and simulated tumor decompression. Computed results demonstrate that gravity and decompression effects account for approximately 40% and 30%, respectively, totaling a 70% recovery of shifting structures with the model. The results also suggest that a non-uniform decompressive stress distribution may be present during tumor resection. Based on this preliminary experience, model predictions constrained by intraoperative surface data appear to be a promising avenue for correcting brain shift during surgery. However, additional clinical cases where volumetric intraoperative MR data is available are needed to improve the understanding of tissue mechanics during resection.
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Hill, D.L.G., Maurer, C.R., Maciunas, R.J., Barwise, J.A., Fitzpatrick, J.M., Wang, M.Y.: Measurement of intraoperative brain surface deformation under a craniotomy. Neurosurgery 43(3), 514–528 (1998)
Roberts, D.W., Hartov, A., Kennedy, F.E., Miga, M.I., Paulsen, K.D.: Intraoperative brain shift and deformation: a quantitative clinical analysis of cortical displacements in 28 cases. Neurosurgery 43(4), 749–760 (1998)
Black, P.M., Moriarty, T., Alexander, E., Stieg, P., Woodard, E.J., Gleason, P.L., Martin, C.H., Kikinis, R., Schwartz, R.B., Jolesz, F.A.: Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery 41(4), 831–842 (1997)
Tronnier, V.M., Wirtz, C.R., Knauth, M., Lenz, G., Pastyr, O., Bonsanto, M.M., Albert, F.K., Kuth, R., Staubert, A., Schlegel, W., Sartor, K., Kunze, S.: Intraoperative diagnostic and interventional magnetic resonance imaging in neurosurgery. Neurosurgery 40(5), 891–900 (1997)
Knauth, M., Wirtz, C.R., Tronnier, V.M., Aras, N., Kunze, S., Sartor, K.: Intraoperative MR increases the extent of tumor resection in patients with highgrade gliomas. Am. J. Neuroradiol. 20(9), 1642–1646 (1999)
Knauth, M., Aras, N., Wirtz, C.R., Dorfler, A., Engelhorn, T., Sartor, K.: Surgically induced intracranial contrast enhancement: Potential source of diagnostic error in intraoperative MR imaging. Am. J. Neuroradiol. 20(8), 1547–1553 (1999)
Kelly, P.J.: Craniotomy for tumor treatment in an intraoperative magnetic resonance imaging unit - COMMENT. Neurosurgery 45(3), 432–433 (1999)
Wirtz, C.R., Bonsanto, M.M., Knauth, M., Tronnier, V.M., Albert, F.K., Staubert, A., Kunze, S.: Intraoperative magnetic resonance imaging to update interactive navigation in neurosurgery: Method and preliminary experience. Computer Aided Surgery 2, 172–179 (1997)
Tronnier, V.M.: Craniotomy for tumor treatment in an intraoperative magnetic resonance imaging unit - COMMENT. Neurosurgery 45(3), 431–432 (1999)
Roberts, D.W., Miga, M.I., Kennedy, F.E., Hartov, A., Paulsen, K.D.: Intraoperatively updated neuroimaging using brain modeling and sparse data. Neurosurgery 45(5), 1199–1207 (1999)
Miga, M.I., Paulsen, K.D., Hoopes, P.J., Kennedy, F.E., Hartov, A., Roberts, D.W.: In vivo quantification of a homogeneous brain deformation model for updating preoperative images during surgery. IEEE Transactions on Biomedical Engineering 47(2), 266–273 (2000)
Miga, M.I., Paulsen, K.D., Lemery, J.M., Eisner, S.D., Hartov, A., Kennedy, F.E., Roberts, D.W.: Model-updated image guidance: Initial clinical experiences with gravity-induced brain deformation. IEEE Trans. Med. Imaging 18(10), 866–874 (1999)
Wirtz, C.R., Tronnier, V.M., Albert, F.K., Knauth, M., Bonsanto, M.M., Staubert, A., Pastyr, O., Kunze, S.: Modified headholder and operating table for intra-operative MRI in neurosurgery. Neurol. Res. 20(7), 658–661 (1998)
Wirtz, C.R., Tronnier, V.M., Bonsanto, M.M., Staubert, A., Albert, F.K., Kunze, S.: Image-guided neurosurgery with intraoperative MRI: update of frameless stereotaxy and radicality control. Stereotact. Funct. Neurosurg. 68, 39–43 (1997)
Biot, M.A.: General theory of three-dimensional consolidation. J. App. Physics 12, 155–164 (1941)
Paulsen, K.D., Miga, M.I., Kennedy, F.E., Hoopes, P.J., Hartov, A., Roberts, D.W.: A computational model for tracking subsurface tissue deformation during stereotactic neurosurgery. IEEE Trans. Biomed. Eng. 46(2), 213–225 (1999)
Miga, M.I., Paulsen, K.D., Kennedy, F.E.: Von neumann stability analysis of Biot’s general two-dimensional theory of consolidation. Int. J. of Num. Methods in Eng. 43, 955–974 (1998)
Miga, M.I., Paulsen, K.D., Hoopes, P.J., Kennedy, F.E., Hartov, A., Roberts, D.W.: In-vivo analysis of heterogeneous brain deformation computations for model-updated image guidance. Computer Methods in Biomechanics and Biomedical Engineering 3, 129–146 (2000)
Miga, M.I., Paulsen, K.D., Hoopes, P.J., Kennedy, F.E., Hartov, A., Roberts, D.W.: In vivo modeling of interstitial pressure in the brain under surgical load using finite elements. ASME J. Biomech. Eng. (2000) (in press)
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Miga, M.I. et al. (2000). Model-Updated Image-Guided Neurosurgery: Preliminary Analysis Using Intraoperative MR. In: Delp, S.L., DiGoia, A.M., Jaramaz, B. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2000. MICCAI 2000. Lecture Notes in Computer Science, vol 1935. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-40899-4_12
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DOI: https://doi.org/10.1007/978-3-540-40899-4_12
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