|Budget Amount *help
¥10,600,000 (Direct Cost : ¥10,600,000)
Fiscal Year 1999 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1998 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1997 : ¥9,000,000 (Direct Cost : ¥9,000,000)
We developed a preoperative simulation and intraoperative navigation system for use with three-dimensional functional mapping in intracranial surgery. This system enables three-dimensional integration of magnetic resonance (MR) and computerized tomography (CT) images, and thereby yields computer graphic composites of the scalp, brain, skull, vessels, and lesions. We investigated the efficacy of a neurosurgical navigation system using three-dimensional composite computer graphics (CGs) of MR and CT images in intracranial surgery.
We used three-point transformation for integration of MR and CT images. MR and CT image data were obtained with three skin markers placed on the patient's scalp. The data were subjected to volume-rendering manipulations to produce three-dimensional CGs of the scalp, brain and lesions from MR, and the scalp and skull from CT. Composite CGs of the scalp, skull, brain, and lesion were created by registering the three markers on the three-dimensional rendered scalp
images obtained from MR and CT in the system. We also improved a three-dimensional digitizer for intraoperative navigation using an articulated arm with an interchangeable probe shaped like a bayonet, which can be used in deep structures through narrow openings.
This system was used for 85 patients during open brain surgery, including 14 patients with skull base lesions. The use of this system for stereotactic craniotomy increased the safety of the surgery by affording preoperative simulation-and intraoperative navigation with the three-dimensional composite CGs. In skull base surgery, simulation of surgical procedures on composite CGs using our system aided comprehension of skull base anatomy and provided optimal approaches. Intraoperative navigation aided determination of actual spatial position in the skull base and the optimal trajectory to the tumor during surgical procedures.