Brain Shift and Updated Intraoperative Navigation with Intraoperative MRI
Image-guided navigation provides a valuable adjunct to neurosurgical procedures. However, since the brain is not a rigid body, intraoperative changes, summarized as “brain shift”, represent a major practical and theoretical challenge. Intraoperative imaging, in particular intraoperative MRI to update information on computer-assisted navigation systems, solves the practical issue. However, capturing, characterizing and modelling brain deformation have opened interesting research avenues, which may lead to a more thorough understanding of the biomechanical properties of the brain. Potential applications go beyond surgical simulation. Obtaining data on the viscoelastic properties of the brain may yield valuable information in regard to physiological (e.g. ageing) as well as pathological conditions (reactions to traumatic brain injuries as well as degenerative diseases).
In this chapter, we portray the development of “brain shift” characterization and potential future directions, as well as the development and practical application of updated surgical navigation with intraoperative MRI.
KeywordsTraumatic Brain Injury Navigation System Brain Shift Traumatic Brain Injury Surface Visualization
Without the motivation and support of the MRT-Teams in Boston and Kiel neither the clinical routine, nor the data sampling for the scientific analyses would have been possible. The work with the “double doughnut” was done from 1998-2000 at the Brigham and Women´s Hospital (under the tutelage of FA. Jolesz, R. Kikinis, P. McL. Black). The 3D Slicer (programmed by D. Gering) was used for navigation and 3D analyses. In Kiel the program was started in 2005 (Chair: H.M. Mehdorn). IGT is a multidisciplinary effort, involving a lot of colleagues who turned friends over the years! The authors extend their gratitude to all of them.
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