The Clinical Value of Ultrasound based Navigation update in cranial resection procedures

Surgical removal is often the main treatment for tumors. In order to completely remove the entire tumor, it is vital to ensure visualization into the brain to review the borders of the tumor and to not harm healthy tissue. Neuronavigation is a well-accepted method to view inside the brain during surgery. This works like a GPS system providing the neurosurgeon with intraoperative guidance based on preoperatively acquired MRI which are registered to the patient’s anatomy. However, accuracy is affected due to brain shift or the movement of the brain after opening the dura or resection of the tumor. Intraoperative ultrasound navigation can be used to compensate for brain shift by providing updated real-time accurate information of the surgical field. the real-time ultrasound is fused with the MRI to update its accuracy. This project is intended to quantify the hypothesized improvement in navigation accuracy using Brainlab’sUltrasound Navigation software and determine if using a navigation update feature can compensate for brainshift and therefore improve navigation accuracy and hence, positively influence extent of resection.