Computer-assisted 3D ultrasound-guided neurosurgery: technological contributions, including multimodal registration and advanced display, demonstrating future perspectives.

BACKGROUND: Navigation systems are now frequently being used for guiding surgical procedures. Existing neuronavigation systems suffer from the lack of updated images when tissue changes during surgery as well as from user-friendly displays of all essential images for accurate and safe surgery guidance.

METHODS: We have developed various new technologies for improved neuronavigation. Using intraoperative 3D ultrasound (US) imaging, we have developed various registration algorithms for using and updating a complete multimodal and multivolume 3D map for navigation.

RESULTS: We experienced that advanced multimodal visualization makes it easy to interpret information from several image volumes and modalities simultaneously. Using high quality intraoperative 3D ultrasound, essential preoperative information could be corrected due to brain shift. fMRI and other important preoperative data could then be used together with intraoperative ultrasound imaging for more accurate, safer and improved guidance of therapy.

CONCLUSIONS: We claim that new features, as demonstrated in the present paper, using intraoperative 3D ultrasound in combination with advanced registration and display algorithms will represent important contributions towards more accurate, safer and more optimized future patient treatment.