Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 14040-901, Ribeirão Preto, SP, Brazil.
Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 14040-901, Ribeirão Preto, SP, Brazil; Instituto Internacional de Neurociência de Natal Edmond e Lily Safra, Instituto Santos Dumont, Rodovia RN 160 Km 03, 3003, 59280-000, Macaíba, RN, Brazil.
J Neurosci Methods. 2018 Nov 1;309:109-120. doi: 10.1016/j.jneumeth.2018.08.023. Epub 2018 Aug 24.
Neuronavigation provides visual guidance of an instrument during procedures of neurological interventions, and has been shown to be a valuable tool for accurately positioning transcranial magnetic stimulation (TMS) coils relative to an individual's anatomy. Despite the importance of neuronavigation, its high cost, low portability, and low availability of magnetic resonance imaging facilities limit its insertion in research and clinical environments.
We have developed and validated the InVesalius Navigator as the first free, open-source software for image-guided navigated TMS, compatible with multiple tracking devices. A point-based, co-registration algorithm and a guiding interface were designed for tracking any instrument (e.g. TMS coils) relative to an individual's anatomy.
Localization, precision errors, and repeatability were measured for two tracking devices during navigation in a phantom and in a simulated TMS study. Errors were measured in two commercial navigated TMS systems for comparison. Localization error was about 1.5 mm, and repeatability was about 1 mm for translation and 1° for rotation angles, both within limits established in the literature.
Existing TMS neuronavigation software programs are not compatible with multiple tracking devices, and do not provide an easy to implement platform for custom tools. Moreover, commercial alternatives are expensive with limited portability.
InVesalius Navigator might contribute to improving spatial accuracy and the reliability of techniques for brain interventions by means of an intuitive graphical interface. Furthermore, the software can be easily integrated into existing neuroimaging tools, and customized for novel applications such as multi-locus and/or controllable-pulse TMS.
神经导航在神经介入手术中为器械提供视觉引导，已被证明是一种将经颅磁刺激（TMS）线圈相对于个体解剖结构准确定位的有价值工具。尽管神经导航非常重要，但其高成本、低便携性和磁共振成像设施的低可用性限制了它在研究和临床环境中的应用。
我们开发并验证了 InVesalius Navigator，它是第一个用于图像引导导航 TMS 的免费开源软件，与多种跟踪设备兼容。我们设计了基于点的配准算法和引导界面，用于跟踪任何器械（例如 TMS 线圈）相对于个体解剖结构的位置。
在模拟 TMS 研究中，在体模和模拟 TMS 研究中，我们测量了两个跟踪设备在导航过程中的定位、精度误差和可重复性。为了进行比较，我们还在两个商业化的导航 TMS 系统中测量了误差。定位误差约为 1.5 毫米，平移的重复性误差约为 1 毫米，旋转角度的重复性误差约为 1 度，均在文献中规定的范围内。
现有的 TMS 神经导航软件程序与多种跟踪设备不兼容，并且没有为自定义工具提供易于实现的平台。此外，商业替代品价格昂贵，便携性有限。
InVesalius Navigator 通过直观的图形界面，可能有助于提高脑介入技术的空间准确性和可靠性。此外，该软件可以轻松集成到现有的神经影像学工具中，并针对多靶点和/或可控脉冲 TMS 等新应用进行定制。
