Improved Neuronavigation through Integration of Intraoperative Anatomical and Diffusion Images in an Interventional MRI Suite

Abstract

Integration of information from complementary imaging mo-dalities in medical image registration schemes potentially improves the registration accuracy. MRI is now being used for guidance of various neurosurgical procedures like anterior temporal lobe resection in patients with refractory temporal lobe epilepsy. Accurate localisation of critical white matter tracts, such as the optic radiation, during neurosurgery is critical in ensuring good patient outcome. Current commercial interventional MR scanners are capable of performing anatomical and diffusion weighted imaging. We propose a near real-time multivariate registration scheme that uses both anatomical and diffusion images from the pre and intraoperative imaging sessions. The registration framework is optimized for use on graphical processing units and we perform a full multivariate non-rigid registration in under three minutes making the proposed framework suitable for use under the stringent time constraints of neurosurgical procedures. We assess the accuracy of our algorithm using a numerical phantom and demonstrate accurate localisation of the optic radiation in clinical datasets. This work could be of significant utility in image guided interventions and facilitate effective surgical treatments.