Li Ping, Wang Weiwei, Song Zhijian, An Yong, Zhang Chenxi
Digital Medical Research Center, Fudan University, Shanghai , 200032, People's Republic of China,
Int J Comput Assist Radiol Surg. 2014 Jul;9(4):669-81. doi: 10.1007/s11548-013-0958-8. Epub 2013 Nov 30.
Brain retraction causes great distortion that limits the accuracy of an image-guided neurosurgery system that uses preoperative images. Therefore, brain retraction correction is an important intraoperative clinical application.
We used a linear elastic biomechanical model, which deforms based on the eXtended Finite Element Method (XFEM) within a framework for brain retraction correction. In particular, a laser range scanner was introduced to obtain a surface point cloud of the exposed surgical field including retractors inserted into the brain. A brain retraction surface tracking algorithm converted these point clouds into boundary conditions applied to XFEM modeling that drive brain deformation. To test the framework, we performed a brain phantom experiment involving the retraction of tissue. Pairs of the modified Hausdorff distance between Canny edges extracted from model-updated images, pre-retraction, and post-retraction CT images were compared to evaluate the morphological alignment of our framework. Furthermore, the measured displacements of beads embedded in the brain phantom and the predicted ones were compared to evaluate numerical performance.
The modified Hausdorff distance of 19 pairs of images decreased from 1.10 to 0.76 mm. The forecast error of 23 stainless steel beads in the phantom was between 0 and 1.73 mm (mean 1.19 mm). The correction accuracy varied between 52.8 and 100 % (mean 81.4 %).
The results demonstrate that the brain retraction compensation can be incorporated intraoperatively into the model-updating process in image-guided neurosurgery systems.
脑牵拉会导致严重变形,这限制了使用术前图像的图像引导神经外科手术系统的准确性。因此,脑牵拉校正成为一项重要的术中临床应用。
我们使用了一种线性弹性生物力学模型,该模型在脑牵拉校正框架内基于扩展有限元方法(XFEM)发生变形。具体而言,引入了激光测距扫描仪以获取暴露手术区域的表面点云,包括插入脑内的牵开器。一种脑牵拉表面跟踪算法将这些点云转换为应用于XFEM建模的边界条件,从而驱动脑变形。为测试该框架,我们进行了一项涉及组织牵拉的脑模型实验。比较了从模型更新图像、牵拉前和牵拉后CT图像中提取的Canny边缘之间的修正豪斯多夫距离对,以评估我们框架的形态对齐情况。此外,比较了嵌入脑模型中的珠子的测量位移和预测位移,以评估数值性能。
19对图像的修正豪斯多夫距离从1.10毫米降至0.76毫米。模型中23个不锈钢珠子的预测误差在0至1.73毫米之间(平均1.19毫米)。校正精度在52.8%至100%之间变化(平均81.4%)。
结果表明,脑牵拉补偿可在术中纳入图像引导神经外科手术系统的模型更新过程。