Volumetric Measurements of Brain Shift Using Intraoperative Cone-Beam Computed Tomography: Preliminary Study. Issue 1 (March 2016) - Pereira, Vitor Mendes
Abstract : BACKGROUND: Cerebrospinal fluid leakage and ventricular compression during open surgery may lead to brain deformation called brain shift. Brain shift may affect intraoperative navigation that is based on image-based preoperative planning. Tools to correct or predict these anatomic modifications can be important to maintain precision during open guided neurosurgery. OBJECTIVE: To obtain a reliable intraoperative volumetric deformation vector field describing brain shift during intracranial neurosurgical procedures. METHODS: We acquired preoperative and intraoperative cone-beam computed tomography enhanced with intravenous injection of iodine contrast. These data sets were preprocessed and elastically registered to obtain the volumetric brain shift deformation vector fields. RESULTS: We obtained the brain shift deformation vector field in 9 cases. The deformation fields proved to be highly nonlinear, particularly around the ventricles. Interpatient variability was considerable, with a maximum deformation ranging from 8.1 to 26.6 mm and a standard deviation ranging from 0.9 to 4.9 mm. CONCLUSION: Contrast-enhanced cone-beam computed tomography provides a feasible technique for intraoperatively determining brain shift deformation vector fields. This technique can be used perioperatively to adjust preoperative planning and coregistration during neurosurgical procedures. ABBREVIATIONS: CBCT, cone-beam computer tomography HU, Hounsfield units