Abstract

This paper presents new methods for the optimal selection of anatomical landmarks and optimal placement of fiducial markers in image-guided neurosurgery. These methods allow the surgeon to optimally plan fiducial marker locations on routine diagnostic images before preoperative imaging and to intraoperatively select the set of fiducial markers and anatomical landmarks that minimize the expected target registration error (TRE). The optimization relies on a novel empirical simulation-based TRE estimation method built on actual fiducial localization error (FLE) data. Our methods take the guesswork out of the registration process and can reduce localization error without additional imaging and hardware. Our clinical experiments on five patients who underwent brain surgery with a navigation system show that optimizing one marker location and the anatomical landmarks configuration reduced the TRE. The average TRE values using the usual fiducials setup and using the suggested method were 4.7 mm and 3.2 mm, respectively. We observed a maximum improvement of 4 mm. Reducing the target registration error has the potential to support safer and more accurate minimally invasive neurosurgical procedures.

Fiducial Optimization for Minimal Target Registration Error in Image-Guided Neurosurgery
Reuben R. Shamir
Reuben R. Shamir
School of Engineering and Computer Science, The Hebrew University of Jerusalem
Phone +972-77-200-5991
Second email: shamir.ruby@gmail.com

Computer Aided Medical Procedures, Technische Universität München, Germany

The Edmond and Lily Safra Center for Brain Research (ELSC)

Center for Functional and Restorative
Neurosurgery, Department of Neurosurgery, Hadassah University Hospital, Ein-Karem, Jerusalem , Israel
Leo Joskowicz
Leo Joskowicz
School of Computer Science and Engineering, Computer-Aided Surgery and Medical Image Processing Laboratory, The Hebrew University of Jerusalem, Givat Ram Campus, Jerusalem 91904, Israel
Tel : +972-2-658-6299, Fax : +972-2-658-6459

The Edmond and Lily Safra Center for Brain Research (ELSC)
Yigal Shoshan
Yigal Shoshan
Department of Neurosurgery, School of Medicine, Hadassah University Hospital, Jerusalem, Israel