Coregistered intraoperative ultrasonography in resection of malignant glioma.

Object: The authors present their experience with coregistration of preoperative imaging data to intraoperative ultrasonography in the resection of high-grade gliomas, focusing on methodology and clinical observation.

Methods: Images were obtained preoperatively and coregistered to intraoperative hand-held ultrasound images by merging the respective imaging coordinate systems. After patient registration and imaging calibration, the authors computed the location on the magnetic resonance (MR) space of each pixel on an ultrasound image acquired in the operating room.

A noncontacting 3-D digitizer for use in image-guided neurosurgery.

Current neuronavigational systems face two primary challenges: (1) automatic and robust registration between preoperative images and the operating room space, and (2) compensation for brain deformations that compromise the accuracy of the initial registration. To contend with these difficulties, we firstly estimate the three-dimensional (3-D) structure of the cortical surface using a noncontacting 3-D digitizer. This 3-D structure is then used to establish the initial registration, and to update the preoperative MR volume as the brain deforms.