A fast, robust, accurate, and automatic registration technique based on magnetic resonance (MR) active microcoils (active markers) for registration of tracked medical devices to preprocedural MR-images is presented. This allows for a straight-forward integration of position measurement systems into clinical procedures. The presented method is useful for guidance purposes in clinical applications with high demands on accuracy and ease-of-use (e.g., neurosurgical or orthopedic applications). The determination of the positions of the active markers is integrated into the preparation phase of the actual MR imaging scan. The technique features a generic interface using DICOM standards for communication with navigation workstations linked to an MR system. The position of the active markers is fixed with respect to a reference system of an optical positioning measurement system (OPMS) and thus the coregistration of the MR system and the OPMS is established. In a phantom study, a mean overall targeting accuracy of 0.9+/-0.1 mm was achieved and compared favorably to results obtained from manual registration tests (1.8+/-0.3 mm) carried out in parallel. For a test person trained for both registration methods, workflow improvements of 3-6 min per registration step were found. The need for manual interaction is entirely eliminated thus avoiding user-bias, which is advantageous for the usage in clinical routine. The method improves the ease-of-use of tracking equipment during stereotactic guidance. The method is finally demonstrated in a volunteer study using a model of a Mayfield skull clamp with integrated active and optical reference markers.

We present a new algorithm for the nonrigid registration of three-dimensional magnetic resonance (MR) intraoperative image sequences showing brain shift. The algorithm tracks key surfaces of objects (cortical surface and the lateral ventricles) in the image sequence using a deformable surface matching algorithm. The volumetric deformation field of the objects is then inferred from the displacements at the boundary surfaces using a linear elastic biomechanical finite-element model. Two experiments on synthetic image sequences are presented, as well as an initial experiment on intraoperative MR images showing brain shift. The results of the registration algorithm show a good correlation of the internal brain structures after deformation, and a good capability of measuring surface as well as subsurface shift. We measured distances between landmarks in the deformed initial image and the corresponding landmarks in the target scan. Cortical surface shifts of up to 10 mm and subsurface shifts of up to 6 mm were recovered with an accuracy of 1 mm or less and 3 mm or less respectively.

Curve evolution schemes for segmentation, implemented with level set methods, have become an important approach in computer vision. Previous work has modeled evolving contours which are curves in 2D or surfaces in 3D. Our objective is to explore recent mathematical work enabling the evolution of manifolds of higher co-dimension. We consider 1D curves in 3D (codimension-two) for the application of automatically, segmenting blood vessels in volumetric magnetic resonance angiography (MRA) images. This paper describes the theoretical foundations of our system, CURVES, then provides segmentation results compared against segmentation obtained interactively by a neurosurgeon. Segmentation of bronchi in lung computed tomography (CT) scans are also presented. The new experiments, comparisons to manual segmentation, and sample comparison to the use of a codimension-one regularization force are the primary contributions of this report.

We aimed to study the performance of a parallel implementation of an intraoperative nonrigid registration algorithm that accurately simulates the biomechanical properties of the brain and its deformations during surgery. The algorithm was designed to allow for improved surgical navigation and quantitative monitoring of treatment progress in order to improve the surgical outcome and to reduce the time required in the operating room. We have applied the algorithm to two neurosurgery cases with promising results. High performance computing is a key enabling technology that allows the biomechanical simulation to be executed quickly enough for the algorithm to be practical. Our parallel implementation was evaluated on a symmetric multi-processor and two clusters and exhibited similar performance characteristics on each. The implementation was sufficiently fast to be used in the operating room during a neurosurgery procedure. It allowed a three-dimensional volumetric deformation to be simulated in less than ten seconds.