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Non-rigid alignment of pre-operative MRI, fMRI, and DT-MRI with intra-operative MRI for enhanced visualization and navigation in image-guided neurosurgery

Institution:	1Computational Radiology Laboratory, Departments of Radiology, Children’s Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA. 2Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. 3Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. 4Computer Science Department, College of William and Mary, Williamsburg, VA, USA.
Publisher:	Neuroimage
Publication Date:	Apr-2007
Volume Number:	35
Issue Number:	2
Pages:	609-624
Citation:	Neuroimage. 2007 Apr 1;35(2):609-624.
PubMed ID:	17289403
Keywords:	MRI, fMRI, Image-guided neurosurgery, Navigation systems, Non-rigid registration, Brain, DT-MRI
Appears in Collections:	CRL, NAC, NCIGT, SLICER
Sponsors:	NSF ITR 0426558, a research grant from CIMIT NMSS RG 3478A2/2 NSF ACI-0312980, NSF EIA-0203974 NIH R21 MH067054 NIH R01 RR021885 NIH P41 RR13218 NIH R03 EB006515 NIH U41 RR019703 NIH P01 CA067165.
Generated Citation:	Archip N, Clatz O, Whalen S, Kacher D, Fedorov A, Kot A, Chrisochoides N, Jolesz F, Golby A, Black P, Warfield S. Non-rigid alignment of pre-operative MRI, fMRI, and DT-MRI with intra-operative MRI for enhanced visualization and navigation in image-guided neurosurgery. Neuroimage. 2007 Apr 1;35(2):609-624. PMID: 17289403.
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The usefulness of neurosurgical navigation with current visualizations is seriously compromised by brain shift, which inevitably occurs during the course of the operation, significantly degrading the precise alignment between the pre-operative MR data and the intra-operative shape of the brain. Our objectives were (i) to evaluate the feasibility of non-rigid registration that compensates for the brain deformations within the time constraints imposed by neurosurgery, and (ii) to create augmented reality visualizations of critical structural and functional brain regions during neurosurgery using pre-operatively acquired fMRI and DT-MRI. Materials and methods:Eleven consecutive patients with supratentorial gliomas were included in our study. All underwent surgery at our intra-operative MR imaging-guided therapy facility and have tumors in eloquent brain areas (e.g. precentral gyrus and cortico-spinal tract). Functional MRI and DT-MRI, together with MPRAGE and T2w structural MRI were acquired at 3 T prior to surgery. SPGR and T2w images were acquired with a 0.5 T magnet during each procedure. Quantitative assessment of the alignment accuracy was carried out and compared with current state-of-the-art systems based only on rigid registration. Results:Alignment between pre-operative and intra-operative datasets was successfully carried out during surgery for all patients. Overall, the mean residual displacement remaining after non-rigid registration was 1.82 mm. There is a statistically significant improvement in alignment accuracy utilizing our non-rigid registration in comparison to the currently used technology (p<0.001). Conclusions:We were able to achieve intra-operative rigid and non-rigid registration of (1) pre-operative structural MRI with intra-operative T1w MRI; (2) pre-operative fMRI with intra-operative T1w MRI, and (3) pre-operative DT-MRI with intra-operative T1w MRI. The registration algorithms as implemented were sufficiently robust and rapid to meet the hard real-time constraints of intra-operative surgical decision making. The validation experiments demonstrate that we can accurately compensate for the deformation of the brain and thus can construct an augmented reality visualization to aid the surgeon.

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