Visualization and Planning of Neurosurgical Interventions with Straight Access

1 Medical Robotics Lab, University of Houston2 Computer Graphics and Interactive Media Lab, University of Houston

3 M.D. Anderson Cancer Center, University of Texas, Houston

Nikhil V. Navkar1,2, Nikolaos V. Tsekos1, Jason R. Stafford3, Jeffrey S. Weinberg3, and Zhigang Deng2

IPCAI: 2010

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

The work proposes a technique for simple and efficient visualization of the region of intervention for neurosurgical procedures.

INTRODUCTION:

INTRODUCTION:

The large volume of three dimensional brain data from different imaging modalities pose a major challenge either at the preoperative or the intraoperative stage of an image-guided neurosurgical interventional procedure.

It is difficult to visualize, comprehend and manipulate the data at the same time.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

INTRODUCTION:

This work proposes an approach based on the generation of Access Maps on the surface of the region of intervention.

•Incorporate the information of underlying tissue and visualize it on the outer surface of the patient.

•Offers an intuitive way for a neurosurgeon to quantitatively select the optimal path of access for a given target anatomy.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

In this work the Access Maps consists of :

• Direct Impact Map

• Proximity Map

• Path Length Map

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Preprocessing of data: Head Surface

MRI Data Acquisition

T2 Weighted MRI

Acquisition matrix 256 X 256

Number of slices = 144

Pixel size of 1.0 x 1.0 mm

Interslice distance = 1.0 mm

Segmentation of Images

Thresholding to segment the

region outside the head (like

a negative mold) and then

applying an inversion filter to

get the inside region.

3D Model Generation

Marching cube .

Laplace+HC mesh

smoothing followed by a

low pass filter.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Preprocessing of data: Brain Vascular

MRI Data Acquisition

Time-of-flight (TOF) MRA

Acquisition matrix 768 X 576

Number of slices = 136

Pixel size of 0.3 x 0.3 mm

Interslice distance = 0.6 mm

Segmentation of Images:

Thresholding and applying

connectivity filter based on

region growing by selecting the

base of the vessel as the seed

point.

3D Model Generation

Marching cube.

Mesh smoothing by

a low pass filter.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Preprocessed Data

Normalized Value of Proximity Map

Normalized Value of Path Length Map

Direct Impact Map

Applying Threshold

Applying Threshold

Access Maps

Overview ofProcesses:

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Direct Impact Map :

• Generated by the concept of Ray Casting.

• Projects the shadow of the vital structures on the skin by considering the target as a point source of light.

• Avoids direct impact on the interventional tool on the vital structure.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Direct Impact Map :

If any insertion is made through a point on the map it would directly impact the vital tissue (vessels in the above case).

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Proximity Map :

•Generated by projecting a safe three dimension virtual buffer space encapsulating the vital structures.

• Properties of intervention tool such as deflection, thickness may bring the interventional tool to very close proximity and even puncture the vital tissue.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Proximity Map :

For a given insertion point v on the head surface PR(v) (mm) is the shortest distance between the insertion path and the vital structure.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Proximity Map :

Shows the minimum distance (in mm) which the interventional tool maintains from the vital structure.

0 mm

11.17 mm

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Path Length Map :

•Shorter the distance travel by interventional tool, the less is the risk of trauma (even to non-vital structures).

•Projects the depth of the target from the surface of intervention.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

METHODS:

Path Length Map :

PL(v) is the distance between the given insertion point v and the target.

37.21 mm

132.30 mm

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

RESULTS:

Target(-30,0,0)

Thresholds:PL(v) = 40.26 mm (Path Length Threshold)PR(v) = 4.00 mm (Proximity Threshold)

IP2(-64.76, 2.25, 15.15)

IP1(-30.61,-2.31,59.59)

IP3(-64.06,20.36,0.85)

IP137.99mm

37.9

9mm

39.6

7mm

IP3

PR(IP1)=0.00mm

PR(IP2)=4.00mm

PR(IP3)=4.74mm

IP2

IP3 is the optimal insertion point for given threshold.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

RESULTS:

The camera is placed on the tip of an interventional tool and follows the selected path of insertion.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

RESULTS:

Preliminary evaluation of the effectiveness of the described access maps for different neurosurgical interventional procedures.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

CONCLUSION:

The described Access Maps is an intuitive and simple approach for visualizing 3D multimodal information about the anatomy of the region of intervention and safety of selected insertion paths.

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

ACKNOWLEDGMENTS:

Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the funding agencies.

This work was supported in part by: • NSF CNS-0932272• NSF IIS-0914965 • Texas NHARP 003652-0058-2007

IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.

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IPCAI 2010: Visualization and Planning of Neurosurgical Interventions with Straight Access.