Neuronavigation by Intraoperative Three-dimensional Ultrasound: Initial Experience during Brain Tumor Resection

Abstract OBJECTIVE: Three-dimensional (3-D) ultrasound is an intraoperative imaging modality used in neuronavigation as an alternative to magnetic resonance imaging (MRI). This article summarizes 4 years of clinical experience in the use of intraoperative 3-D ultrasound integrated into neuronavigation for guidance in brain tumor resection. METHODS: Patients were selected for inclusion in the study on the basis of the size and location of their lesion. Preoperative 3-D MRI data were registered and used for planning as in other conventional neuronavigation systems. Intraoperative 3-D ultrasound images were acquired three to six times, and tumor resection was guided on the basis of these updated 3-D images. RESULTS: Intraoperative 3-D ultrasound represents a good solution to the problem of brain shift in neuronavigation because it easily provides an updated, and hence more accurate, map of the patient's true anatomy in all phases of the operation. Ultrasound makes it possible to follow the progression of the operation, and it improves the radicality of tumor resection by detecting tumor tissue that would remain if the imaging technology had not been used (in 53% of the cases). Integration of 3-D ultrasound with navigation technology solves the orientation problem experienced previously with two-dimensional ultrasound in neurosurgery. The technology makes it possible to directly compare intraoperative ultrasound and MRI data regarding visualization of the lesion. Ultrasound image quality is useful for guiding surgical procedures. CONCLUSION: Intraoperative 3-D ultrasound seems to provide a time- and cost-effective way to update high-quality 3-D maps used in neuronavigation.

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Three-dimensional Force Perception of Robotic Bipolar Forceps for Brain Tumor Resection

Journal of Medical Devices ◽

10.1115/1.4051361 ◽

2021 ◽

Author(s):

Xiu-Heng Zhang ◽

Heng Zhang ◽

Zhen Li ◽

Gui-Bin Bian

Keyword(s):

Brain Tumor ◽

Real Time ◽

Force Measurement ◽

Measurement Techniques ◽

Tumor Resection ◽

Three Dimensional ◽

Contact Forces ◽

Surgical Instruments ◽

Force Perception ◽

Brain Tumor Resection

Abstract Three-dimensional force perception is critically important in the enhancement of human force perception to minimize brain injuries resulting from excessive forces applied by surgical instruments in robot-assisted brain tumor resection. And surgeons are not responsive enough to interpret tool-tissue interaction forces. In previous studies, various force measurement techniques have been published. In neurosurgical scenarios, there are still some drawbacks to these presented approaches to forces perception. Because of the narrow, and slim configuration of bipolar forceps, three-dimensional contact forces on forceps tips is not easy to be traced in real-time. Five fundamental acts of handling bipolar forceps are poking, opposing, pressing, opening, and closing. The first three acts independently correspond to the axial force of z, x, y. So, in this paper, typical interactions between bipolar forceps and brain tissues have been analyzed. A three-dimensional force perception technique to collect force data on bipolar forceps tips by installing three Fiber Bragg Grating Sensors (FBGs) on each prong of bipolar forceps in real-time is proposed. Experiments using a tele-neurosurgical robot were performed on an in-vitro pig brain. In the experiments, three-dimensional forces were tracked in real-time. It is possible to experience forces at a minimum of 0.01 N. The three-dimensional force perception range is 0-4 N. The calibrating resolution on x, y, and z, is 0.01, 0.03, 0.1 N, separately. According to our observation, the measurement accuracy precision is over 95%.

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A Novel Platform for Image-guided Ultrasound

Neurosurgery ◽

10.1227/01.neu.0000204454.52414.7a ◽

2006 ◽

Vol 58 (4) ◽

pp. 710-718 ◽

Cited By ~ 48

Author(s):

Wuttipong Tirakotai ◽

Dorothea Miller ◽

Stefan Heinze ◽

Ludwig Benes ◽

Helmut Bertalanffy ◽

...

Keyword(s):

Navigation System ◽

Imaging Modality ◽

Intraoperative Imaging ◽

Intraoperative Ultrasound ◽

Image Data ◽

Cost Effective ◽

Present System ◽

Data Sets ◽

Brain Shift ◽

Ultrasound Device

Abstract OBJECTIVE: The combination of classic neuronavigation and intraoperative ultrasound is a recent innovation in image guidance technology. However, this technique requires two hardware components (neuronavigation and an ultrasound system). It was the aim of the study to describe a new simplified technology of a so-called one-platform navigation system developed by our institution in collaboration with the industry and to demonstrate its range of various applications. METHODS: An ultrasound device (IGSonic; BrainLAB, Munich, Germany) is integrated into the VectorVision2 navigation system (BrainLAB, Munich, Germany). The IGSonic Probe 10V5 is connected to the VectorVision Navigation station via an IGSonic Device Box. Once the ultrasound probe is calibrated, the navigated ultrasound displays the sonographic image of the intracranial anatomy on the navigation screen in a composed overlay fashion. It might depict vascular structures within the ultrasound plane by a duplex mode. Ultrasound can also be operated independently from navigation. RESULTS: The VectorVision2 system combines intraoperative ultrasound data sets with preoperatively acquired neuronavigation data sets in plug and play fashion. The system provides a cost-effective intraoperative imaging modality that offers a good anatomic orientation by various composite images, including the display of the amount of brain shift. In our institution, the comprehensible interface led to a routine use of the technology by several neurosurgeons who had not been familiar with the ultrasound technology before. CONCLUSION: The integration of an ultrasound device into an existing navigation system has been successfully developed. The system offers a friendly user interface and cost-effective intraoperative imaging feedback. Although brain shift can be visualized by an image overlay technology as demonstrated by the present system, future developments should aim at fusion techniques of both intra- and preoperative image data sets.

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