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Preoperative Three-Dimensional Model Creation of Magnetic Resonance Brain Images as a Tool to Assist Neurosurgical Planning

Spottiswoode B.S.a,c,g · van den Heever D.J.d · Chang Y.b · Engelhardt S.h · Du Plessis S.e · Nicolls F.b · Hartzenberg H.B.f · Gretschel A.f
aMRC/UCT Medical Imaging Research Unit, Department of Human Biology, and bDepartment of Electrical Engineering, University of Cape Town, Cape Town, cDivision of Radiology, dBiomedical Engineering Research Group, Department of Mechanical and Mechatronic Engineering, eDepartment of Psychiatry, and fDivision of Neurosurgery, Stellenbosch University, Stellenbosch, South Africa; gCardiovascular MR R&D, Siemens Healthcare, Chicago, Ill., USA; hComputational Visualistics, University of Koblenz-Landau, Koblenz, Germany Stereotact Funct Neurosurg 2013;91:162-169 (DOI:10.1159/000345264)


Background: Neurosurgeons regularly plan their surgery using magnetic resonance imaging (MRI) images, which may show a clear distinction between the area to be resected and the surrounding healthy brain tissue depending on the nature of the pathology. However, this distinction is often unclear with the naked eye during the surgical intervention, and it may be difficult to infer depth and an accurate volumetric interpretation from a series of MRI image slices. Objectives: In this work, MRI data are used to create affordable patient-specific 3-dimensional (3D) scale models of the brain which clearly indicate the location and extent of a tumour relative to brain surface features and important adjacent structures. Methods: This is achieved using custom software and rapid prototyping. In addition, functionally eloquent areas identified using functional MRI are integrated into the 3D models. Results: Preliminary in vivo results are presented for 2 patients. The accuracy of the technique was estimated both theoretically and by printing a geometrical phantom, with mean dimensional errors of less than 0.5 mm observed. Conclusions: This may provide a practical and cost-effective tool which can be used for training, and during neurosurgical planning and intervention.


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