Minim Invasive Neurosurg 2006; 49(4): 197-202
DOI: 10.1055/s-2006-947997
Original Article

© Georg Thieme Verlag KG · Stuttgart · New York

Application of Intraoperative 3D Ultrasound During Navigated Tumor Resection

D. Lindner 1 , 5 , C. Trantakis 1 , 5 , C. Renner 1 , S. Arnold 3 , A. Schmitgen 4 , J. Schneider 2 , J. Meixensberger 1 , 5
  • 1Klinik für Neurochirurgie, Universität Leipzig, Leipzig, Germany
  • 2Klinik für Diagnostische Radiologie, Universität Leipzig, Leipzig, Germany
  • 3Fraunhofer Institut für Angewandte Informationstechnik FIT, St. Augustin, Germany
  • 4Localite, Bonn, Germany
  • 5Innovations Centrum Computer Assistierte Chirurgie ICCAS, Leipzig, Germany
Further Information

Publication History

Publication Date:
13 October 2006 (online)

Preview

Abstract

Intraoperative 3D ultrasound (3D-iUS) may enhance the quality of neuronavigation by adding information about brain shift and tumor remnants. The aim of our study was to prove the concept of 3D ultrasound on the basis of technical and human effects. A 3D-ultrasound navigation system consisting of a standard personal computer containing a video grabber card in combination with an optical tracking system (NDI Polaris) and a standard ultrasound device (Siemens Omnia) with a 7.5 MHz probe was used. 3D-iUS datasets were acquired after craniotomy, at different subsequent times of the procedure and overlaid with preoperative MRI. All patients underwent early postoperative 3D MRI including contrast agent within 24 hours after surgery. Acquisition of 3D iUS and the fusion with preoperative MRI was successful in 22/23 patients. The expenditure of time was at least 5 minutes for one intraoperative 3D US dataset. The technique was used three to seven times during surgery. The quality of the ultrasound images was superior in cases of metastasis, meningeoma and angioma over those in malignant glioma. Brain shifting ranged from 2-25 mm depending on localization and kind of tumor. A resection control was possible in 78%. All six neurosurgeons demonstrated a learning curve. The introduction of 3D ultrasound has increased the value of neuronavigation substantially, making it possible to update several times during surgery and minimize the problem of brain shift. Configuration of both the 3D iUS based on a standard ultrasound system and the MR navigation system is time- and especially cost-effective. Faster navigational datasets and more intuitive image-guided surgery enable novel and user-friendly display techniques.

References

Correspondence

Dr. med. Dirk Lindner

Department of Neurosurgery·University of Leipzig

Liebigstraße 20

04103 Leipzig

Germany

Phone: +49/341/971 75 00

Fax: +49/341/971 75 09

Email: dlind@medizin.uni-leipzig.de