Investigation of intraoperative brain deformation using a 1.5-T interventional MR system: preliminary results

All image-guided neurosurgical systems that the authors are aware of assume that the head and its contents behave as a rigid body. It is important to measure intraoperative brain deformation (brain shift) to provide some indication of the application accuracy of image-guided surgical systems, and also to provide data to develop and validate nonrigid registration algorithms to correct for such deformation. The authors are collecting data from patients undergoing neurosurgery in a high-field (1.5 T) interventional magnetic resonance (MR) scanner. High-contrast and high-resolution gradient-echo MR image volumes are collected immediately prior to surgery, during surgery, and at the end of surgery, with the patient intubated and lying on the operating table in the operative position. Here, the authors report initial results from six patients: one freehand biopsy, one stereotactic functional procedure, and four resections. The authors investigate intraoperative brain deformation by examining threshold boundary overlays and difference images and by measuring ventricular volume. They also present preliminary results obtained using a nonrigid registration algorithm to quantify deformation. They found that some cases had much greater deformation than others, and also that, regardless of the procedure, there was very little deformation of the midline, the tentorium, the hemisphere contralateral to the procedure, and ipsilateral structures except those that are within 1 cm of the lesion or are gravitationally above the surgical site.