IBIS: an OR ready open-source platform for image-guided neurosurgery



Navigation systems commonly used in neurosurgery suffer from two main drawbacks: (1) their accuracy degrades over the course of the operation and (2) they require the surgeon to mentally map images from the monitor to the patient. In this paper, we introduce the Intraoperative Brain Imaging System (IBIS), an open-source image-guided neurosurgery research platform that implements a novel workflow where navigation accuracy is improved using tracked intraoperative ultrasound (iUS) and the visualization of navigation information is facilitated through the use of augmented reality (AR).


The IBIS platform allows a surgeon to capture tracked iUS images and use them to automatically update preoperative patient models and plans through fast GPU-based reconstruction and registration methods. Navigation, resection and iUS-based brain shift correction can all be performed using an AR view. IBIS has an intuitive graphical user interface for the calibration of a US probe, a surgical pointer as well as video devices used for AR (e.g., a surgical microscope).


The components of IBIS have been validated in the laboratory and evaluated in the operating room. Image-to-patient registration accuracy is on the order of \(3.72\pm 1.27\,\hbox {mm}\) and can be improved with iUS to a median target registration error of 2.54 mm. The accuracy of the US probe calibration is between 0.49 and 0.82 mm. The average reprojection error of the AR system is \(0.37\pm 0.19\,\hbox {mm}\). The system has been used in the operating room for various types of surgery, including brain tumor resection, vascular neurosurgery, spine surgery and DBS electrode implantation.


The IBIS platform is a validated system that allows researchers to quickly bring the results of their work into the operating room for evaluation. It is the first open-source navigation system to provide a complete solution for AR visualization.

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This work was financed by the Fonds Québécois de la recherche sur la nature et les technologies, the Canadian Institute of Health Research (MOP-97820) and the Natural Science and Engineering Research Council of Canada.

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Correspondence to Simon Drouin.

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Conflict of interest

Simon Drouin, Anna Kochanowska, Marta Kersten-Oertel, Ian J. Gerard, Rina Zelmann, Dante De Nigris, Silvain Bériault, Tal Arbel, Denis Sirhan, Abbas F. Sadikot, Jeffery A. Hall, David S. Sinclair, Kevin Petrecca, Rolando F. DelMaestro and D. Louis Collins Collins declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 [57].

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Informed consent was obtained from all patients for being included in the study.

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Drouin, S., Kochanowska, A., Kersten-Oertel, M. et al. IBIS: an OR ready open-source platform for image-guided neurosurgery. Int J CARS 12, 363–378 (2017). https://doi.org/10.1007/s11548-016-1478-0

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  • Image-guided surgery
  • Ultrasound
  • Augmented reality
  • Brain shift correction