Components of LRS tracking system. (a) LRS with 12 IRED distribution on the surfaces, (b) optical tracking cameras, (c) pen probe with 20 IRED around the surface, (d) customized cart holding the host computer and control box of the Optotrak Certus system, and (e) arm stand and data collection in the OR.
Data acquired by LRS intraoperatively (a)–(f) and preMRI (g),(h). (a) 3D point cloud of cortical surface, (b) textured 3D point cloud of the cortical surface, (c) high-resolution 2D image, (d) 3D point cloud of face scan, (e) textured 3D point cloud of face scan, (f) tracked skin markers in patient space, (g) head surface, (h) texture brain surface. The obstructing object in (d), and (e) is to protect patient confidentiality.
Target points identified on LRS cortical surface (a),(c) and textured MRI brain surface (b),(d) for Patient 11 and Patient 10, respectively.
The relationship between RMS FRE, RMS TRE, and the number of skin fiducial markers. These results show the relationship between standard registration errors and the number of fiducials used for PBR.
Visualization of the registration results for both skin fiducial PBR and face-ICP. (a) is the registration result of the face from LRS and MR using skin fiducial PBR. (b) is the registration result of the face from LRS and MR using face-based ICP. (c) uses the same registration transformation as (a) but shows the cortical surface and MR counterpart in the visualization, (d) uses the same registration transformation as (b) but shows the cortical surface and MR counterpart in the visualization. Arrow points to continuation of vessel area between MR and LRS surfaces.
Visualization of the registration results for patient 1 using all four methods of cortical surface registration. Each image shows overlay between the cortical brain surface as acquired by LRS and the corresponding grayscale encoded MRI brain surface. The transformations are: (a) feature PBR, (b) vessel ICP, (c) SurfaceMl, and (d) constrained surfaceMI. The arrows point to the continuation of vessel area between MR and LRS surfaces.
Visualization of the registration result for each patient using the same overlay as in Fig. 6. The transformations used for each patient are: (a) patient 2, vessel ICP, (b) patient 3, constrained SurfaceMI, (c) patient 4, constrained SurfaceMI, (d) patient 5, vessel ICP, (e) patient 6, feature PBR, (f) patient 7, feature PBR, (g) patient 8, feature PBR, (h) patient 9, feature PBR, (i) patient 10, SurfaceMI, and (j) patient 11, constrained SurfaceMI. The arrows point to the continuation of vessel area between MR and LRS surfaces. Patient 1 is shown in Fig. 6.
Texture images of the intraoperative cortical surface for patient 8 (a) with swelling and patient 7 (b) with sagging of intraoperative brain surface deformation. These were acquired post dural opening and demonstrate the presence of shift already present at the initiation of surgery. Even the most accurate extracranial registration technique (bone-implanted markers) would still be confounded by shift.
Patient Information. Tumor Types: Gr—Grade, Olig.—Oligodendroglioma, Mening.—Meningioma, Astro.—Astrocytoma, GBM—Glioblastoma Multiforme, Met.—Metastatic Tumor. Location: L: left, R: right, F: frontal, T: temporal, P: parietal. Standard of care also involved a gram dose per kg of patient weight of mannitol for all patients, and general anesthesia.
Skin marker digitization and registration results using PBR.
Initial registration accuracy for each patient, RMS-TRE in mm.
RMS FRE for skin fiducial PBR when five best skin fiducials are used in PBR.
Cortical surface registration error results for each patient. The indicates the best performing cortical surface registration among the four methods based on the value of TRE.
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