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DOI: 10.1055/a-2538-3745
Immersive Neurosurgical Anatomy Using Photogrammetry: Technical Note and Scoping Review

Abstract
Introduction Photogrammetry holds promise for expanding the domains of microsurgical education. The authors present a technical note and scoping review that explore the use of photogrammetry in neurosurgical anatomy, existing technical guidelines, and areas of implementation.
Methods Photogrammetry was employed to build three-dimensional models of the anatomy of the white matter tracts, brainstem, cranial nerves, and the retrosigmoid approach using human brain and skull specimens. In addition, a scoping review was performed on three databases (PubMed, Scopus, and Embase). Information was collected regarding human models, software, hardware, assessment of high-fidelity reconstruction, and anatomic depth estimation.
Results The illustrative models achieved a high-quality representation of the white matter tracts, brainstem, cranial nerves, and anatomy in the retrosigmoid approach.
Our scoping review yielded 3,620 articles, of which 28 were included in the analysis. Photogrammetry was described in three technical stages: image acquisition, processing, and visualization. About 75% of studies reported high-fidelity image reconstruction, and only 42.9% of articles performed anatomic depth estimation. Concerning microsurgical anatomy education, photogrammetry has primarily rendered digital models of the cranial region (96.4%). During educational sessions, the most common surgical approaches described the orbitozygomatic (20%), endoscopic endonasal (20%), translabyrinthine (13.3%), retrosigmoid (13.3%), and Kawase (13.3%) approaches.
Conclusion Photogrammetry offers an innovative approach to creating portable and virtual anatomical models with high-fidelity and vivid representations of human specimens. The resulting three-dimensional models can provide real proportions to teach visuospatial skills in neurosurgery. However, significant challenges remain to achieve objective accuracy and anatomic depth perception, which are critical for microsurgical education.
Authors' Contributions
J.E.B.B. was responsible for the conception and design of the study. D.B.H. described the technical note, dissected the human specimens, and rendered the photogrammetry models. Data acquisition and revision were carried out by J.E.B.B., D.B.H., K.A., V.E.C.S., C.D.M., G.S., and K.W., while J.E.B.B., D.B.H., G.S., and J.E.C. contributed to the analysis and interpretation of the data. Manuscript writing and revision were undertaken by J.E.B.B., D.B.H., M.Y.F., K.W., S.B., R.B., and M.A.L.G. The study was supervised by R.B. and M.A.L.G.
Publication History
Received: 19 December 2024
Accepted: 12 February 2025
Accepted Manuscript online:
14 February 2025
Article published online:
11 March 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 Ahumada-Vizcaíno JC, Wuo-Silva R, Hernández MM, Chaddad-Neto F. The art of combining neuroanatomy and microsurgical skills in modern neurosurgery. Front Neurol 2023; 13: 1076778
- 2 Al-Fugara A, Al-Adamat R, Alkouri O, Taher S. DSM derived stereo pair photogrammetry: multitemporal morphometric analysis of a quarry in karst terrain. Egypt J Remote Sens Space Sci 2016; 19 (01) 61-72
- 3 Struck R, Cordoni S, Aliotta S, Pérez-Pachón L, Gröning F. Application of photogrammetry in biomedical science. Adv Exp Med Biol 2019; 1120: 121-130
- 4 Azkue JJ. True-color 3D rendering of human anatomy using surface-guided color sampling from cadaver cryosection image data: a practical approach. J Anat 2022; 241 (02) 552-564
- 5 Barbero-García I, Pierdicca R, Paolanti M, Felicetti A, Lerma JL. Combining machine learning and close-range photogrammetry for infant's head 3D measurement: a smartphone-based solution. Measurement 2021;182(109686)
- 6 Aydin SO, Barut O, Yilmaz MO. et al. Use of 3-dimensional modeling and augmented/virtual reality applications in microsurgical neuroanatomy training. Oper Neurosurg (Hagerstown) 2023; 24 (03) 318-323
- 7 Baskaran V, Štrkalj G, Štrkalj M, Di Ieva A. Current applications and future perspectives of the use of 3D printing in anatomical training and neurosurgery. Front Neuroanat 2016; 10: 69
- 8 Byvaltsev V, Polkin R, Bereznyak D. et al. 3D-printed cranial models simulating operative field depth for microvascular training in neurosurgery. Surg Neurol Int 2021; 12 (213) 213
- 9 Carlstrom LP, Perry A, Graffeo CS, Peris-Celda M, Driscoll CLW, Link MJ. Foundations of advanced neuroanatomy: preparation, dissection, and 3D photography of specimens for skull base pedagogy. J Neurological Surgery Part B 2019; x: x
- 10 Chytas D, Paraskevas G, Noussios G. et al. Use of photogrammetry-based digital models in anatomy education: an overview. Morphologie 2024; 108 (363) 100792
- 11 Chae R, Sharon JD, Kournoutas I. et al. Replicating skull base anatomy with 3D technologies: a comparative study using 3D-scanned and 3D-printed models of the temporal bone. Otol Neurotol 2020; 41 (03) e392-e403
- 12 Chandna R, Kuzhuppilly NIR, Kamath YS. Smartphone-acquired image photogrammetry for detection of shallow anterior chamber. Clin Ophthalmol 2021; 15: 1875-1885
- 13 Maan ZN, Maan IN, Darzi AW, Aggarwal R. Systematic review of predictors of surgical performance. Br J Surg 2012; 99 (12) 1610-1621
- 14 Bogomolova K, van der Ham IJM, Dankbaar MEW. et al. The effect of stereoscopic augmented reality visualization on learning anatomy and the modifying effect of visual-spatial abilities: a double-center randomized controlled trial. Anat Sci Educ 2020; 13 (05) 558-567
- 15 Langlois J, Bellemare C, Toulouse J, Wells GA. Spatial abilities and anatomy knowledge assessment: a systematic review. Anat Sci Educ 2017; 10 (03) 235-241
- 16 Langlois J, Bellemare C, Toulouse J, Wells GA. Spatial abilities and technical skills performance in health care: a systematic review. Med Educ 2015; 49 (11) 1065-1085
- 17 Costa A, Bederson JB. 335 a modular, multimodality integrative pipeline for neurosurgery simulation and visualization. Neurosurgery 2016; 63 (01) x
- 18 Bocanegra-Becerra JE, Canaz G, Vatcheva C, Wellington J. Internal carotid artery classification systems: an illustrative review. World Neurosurg 2022; 163: 41-49
- 19 Cullen S, Mackay R, Mohagheghi A, Du X. The use of smartphone photogrammetry to digitise transtibial sockets: optimisation of method and quantitative evaluation of suitability. Sensors (Basel) 2021; 21 (24) 8405
- 20 De Benedictis A, Nocerino E, Menna F. et al. Photogrammetry of the human brain: a novel method for three-dimensional quantitative exploration of the structural connectivity in neurosurgery and neurosciences. World Neurosurg 2018; 115: e279-e291
- 21 de Oliveira ASB, Leonel LCPC, LaHood ER. et al. Foundations and guidelines for high-quality three-dimensional models using photogrammetry: a technical note on the future of neuroanatomy education. Anat Sci Educ 2023; 16 (05) 870-883
- 22 Dębski M, Bajor G, Lepich T, Aniszewski Ł, Jędrusik P. Process of photogrammetry with use of custom made workstation as a method of digital recording of anatomical specimens for scientific and research purposes. Transl Res Anat 2021;24(100128)
- 23 Dixit I, Dunne C, Blumer P, Logan CJ, Prakitpong R, Krebs C. The best of each capture—the combination of 3D laser scanning with photogrammetry for optimized digital anatomy specimens. FASEB J 2020;34(S1)
- 24 Dixit I, Piemontesi J, Kennedy S, Kennedy BW, Krebs C. Photogrammetry or 3D surface scanning—which tool works best for anatomical specimens?. FASEB J 2019;33(S1)
- 25 Tricco AC, Lillie E, Zarin W. et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018; 169 (07) 467-473
- 26 Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005; 8 (01) 19-32
- 27 González-Romo NI, Mignucci-Jiménez G, Hanalıoğlu S. et al. Virtual neurosurgery anatomy laboratory: a collaborative and remote education experience in the metaverse. Surg Neurol Int 2023; 14 (90) 90
- 28 Graffeo CS, Perry A, Carlstrom LP, Link MJ, Morris J. A model is worth 1,000 pictures: applications of 3D-modeling in skull base surgery neuroanatomy education. J Neurological Surgery Part B 2020; 81 (S 01): S1-S272
- 29 Gurses ME, Güngör A, Gökalp E. et al. Three-dimensional modeling and augmented and virtual reality simulations of the white matter anatomy of the cerebrum. Oper Neurosurg (Hagerstown) 2022; 23 (05) 355-366
- 30 Gurses ME, Gonzalez-Romo NI, Xu Y. et al. Interactive microsurgical anatomy education using photogrammetry 3D models and an augmented reality cube. J Neurosurg 2024; 141 (01) 17-26
- 31 Gurses ME, Gungor A, Hanalioglu S. et al. Qlone®: a simple method to create 360-degree photogrammetry-based 3-dimensional model of cadaveric specimens. Oper Neurosurg (Hagerstown) 2021; 21 (06) E488-E493
- 32 Gurses ME, Hanalioglu S, Mignucci-Jiménez G. et al. Three-dimensional modeling and extended reality simulations of the cross-sectional anatomy of the cerebrum, cerebellum, and brainstem. Oper Neurosurg (Hagerstown) 2023; 25 (01) 3-10
- 33 Kournoutas I, Vigo V, Chae R. et al. Acquisition of volumetric models of skull base anatomy using endoscopic endonasal approaches: 3D scanning of deep corridors via photogrammetry. World Neurosurg 2019; 129: 372-377
- 34 Krogager ME, Fugleholm K, Mathiesen TI, Spiriev T. Simplified easy-accessible smartphone-based photogrammetry for 3-dimensional anatomy presentation exemplified with a photorealistic cadaver-based model of the intracranial and extracranial course of the facial nerve. Oper Neurosurg (Hagerstown) 2023; 25 (02) e71-e77
- 35 Leonel L, Alexander Y, Pinheiro-Neto CD, Link MJ, Morris JM, Peris-Celda M. Stereoscopic photogrammetry: technical note on the future of skull base education. J Neurological Surgery Part B 2022; 83 (S 01): S1-S270
- 36 Nicolosi F, Spena G. Three-dimensional virtual intraoperative reconstruction: a novel method to explore a virtual neurosurgical field. World Neurosurg 2020; 137: e189-e193
- 37 Payman A, Rios Zermeno J, Hirpara A, El-Sayed IH, Abla A, Rodriguez Rubio R. Immersive surgical anatomy of the far-lateral approach. Cureus 2022; 14 (11) e31257
- 38 Ravichandiran M, Doglietto F, Qiu J. et al. Quantifying area of access of surgical approaches in neurosurgery using three-dimensional reconstruction. Clin Anat 2011; 24 (08) 1034-1035
- 39 Roh TH, Oh JW, Jang CK. et al. Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education. Neurosurg Focus 2021; 51 (02) E16
- 40 Rodriguez Rubio R, Chae R, Kournoutas I, Abla A, McDermott M. Immersive surgical anatomy of the frontotemporal-orbitozygomatic approach. Cureus 2019; 11 (11) e6053
- 41 Rodriguez RubioR, Xie W, Vigo V. et al. Immersive Surgical Anatomy of the Retrosigmoid Approach. Cureus 2021; 13 (6) e16068
- 42 Rubio RR, Shehata J, Kournoutas I. et al. Construction of neuroanatomical volumetric models using 3-dimensional scanning techniques: technical note and applications. World Neurosurg 2019; 126: 359-368
- 43 Shin J, Forbes J, Lehner K, Tomasiewicz H, Schwartz TH, Phillips CD. Skull base 3D modeling of rigid buttress for gasket-seal closure using operative endoscopic imaging: cadaveric feasibility. J Neurol Surg B Skull Base 2019; 80 (01) 67-71
- 44 Spiriev T, Nakov V, Cornelius JF. Photorealistic 3-dimensional models of the anatomy and neurosurgical approaches to the V2, V3, and V4 segments of the vertebral artery. Oper Neurosurg (Hagerstown) 2023; 25 (01) e15-e21
- 45 Titmus M, Whittaker G, Radunski M. et al. A workflow for the creation of photorealistic 3D cadaveric models using photogrammetry. J Anat 2023; 243 (02) 319-333
- 46 Vigo V, Hirpara A, Yassin M. et al. Immersive surgical anatomy of the craniocervical junction. Cureus 2020; 12 (09) e10364
- 47 Vigo V, Núñez M, Xu Y. et al. The endoscopic endonasal approach to the pituitary gland and medial wall of the cavernous sinus: a stepwise technique using volumetric models from anatomical dissections. J Neurological Surgery Part B 2022; 83 (S 01): S1-S270
- 48 Xu Y, Vigo V, Klein J. et al. A new paradigm for ultra-high definition photography in surgical neuroanatomy. J Neurological Surgery Part B 2023; 84 (S 01): S1-S344
- 49 Spiriev T, Mitev A, Stoykov V, Dimitrov N, Maslarski I, Nakov V. Three-dimensional immersive photorealistic layered dissection of superficial and deep back muscles: anatomical study. Cureus 2022; 14 (07) e26727
- 50 Trandzhiev M, Vezirska DI, Maslarski I. et al. Photogrammetry applied to neurosurgery: a literature review. Cureus 2023; 15 (09) e46251
- 51 Kronig SAJ, Kronig ODM, Vrooman HA, Van Adrichem LNA. UCSQ method applied on 3D photogrammetry: non-invasive objective differentiation between synostotic and positional plagiocephaly. Cleft Palate Craniofac J 2023; 60 (10) 1273-1283
- 52 Legout A, Gibaud B, Barillot C, Moreau JJ. 3-D representation of cerebral blood vessels using photogrammetry and computer graphics. Proceedings of SPIE, The International Society for Optical Engineering/Proceedings of SPIE. 1986;602:295–300
- 53 Leonel L, O'Brien M, Pinheiro-Neto CD, Paúl A, Adamo MA, Peris-Celda M. Pilot study in theoretical and hands-on experience and its contribution to learning of residents and young trainees in neurosurgery. The importance of surgical anatomy laboratories as part of training. J Neurological Surgery Part B 2021; 82 (S 02): S65-S270
- 54 Dumas R, Le Bras A, Champain N. et al. Validation of the relative 3D orientation of vertebrae reconstructed by bi-planar radiography. Med Eng Phys 2004; 26 (05) 415-422
- 55 Gonzalez F, Deshmukh P, Ferreira MA, Zabramski JM, Preul MC, Spetzler RF. The cavernous sinus and middle fossa triangles: contents and clinical importance expanded in 3 dimensions. Skull Base 2001; 11 (SUPPL. 1): 19
- 56 Piazza A, Corvino S, Ballesteros D. et al. Neuroanatomical photogrammetric models using smartphones: a comparison of apps. Acta Neurochir (Wien) 2024; 166 (01) 378
- 57 Piazza A, Bellomo J, Corvino S. et al. Quantitative neuroanatomical measurement on photogrammetric model: validation study. World Neurosurg 2025; 194: 123574
- 58 Matuzevicius D. Smartphone-based photogrammetry for 3D human head reconstruction. International Journal of Imaging and Robotics 2022; 22 (03) 1-12
- 59 Minh Trieu N, Truong Thinh N. The anthropometric measurement of nasal landmark locations by digital 2D photogrammetry using the convolutional neural network. Diagnostics (Basel) 2023; 13 (05) 891
- 60 Aridan N, Bernstein-Eliav M, Gamzo D, Schmeidler M, Tik N, Tavor I. Neuroanatomy in virtual reality: development and pedagogical evaluation of photogrammetry-based 3D brain models. Anat Sci Educ 2024; 17 (02) 239-248
- 61 Nocerino E, Menna F, Remondino Fet al. Application of photogrammetry to brain anatomy. Int Arch Photogramm Remote Sens Spat Inf Sci 2017; XLII-2/W4: 213-219
- 62 Bocanegra-Becerra JE, Castillo-Huerta NM, Ludeña-Esquivel A, Torres-García ON, Vilca-Salas MI, Bermudez-Pelaez MF. The humanitarian aid of neurosurgical missions in Peru: a chronicle and future perspectives. Surg Neurol Int 2022; 13: 545
- 63 Bocanegra-Becerra JE, Acha Sánchez JL, Castilla-Encinas AM. et al. Toward a frontierless collaboration in neurosurgery: a systematic review of remote augmented and virtual reality technologies. World Neurosurg 2024; 187: 114-121