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Critical Reviews™ in Biomedical Engineering
SJR: 0.243 SNIP: 0.376 CiteScore™: 0.79

ISSN Print: 0278-940X
ISSN Online: 1943-619X

Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.v40.i3.20
pages 175-185

Brain Shift Compensation and Neurosurgical Image Fusion Using Intraoperative MRI: Current Status and Future Challenges

Daniela Kuhnt
Department of Neurosurgery, University of Marburg, Germany
Miriam H. A. Bauer
Department of Neurosurgery, University of Marburg, Germany
Christopher Nimsky
Department of Neurosurgery, University of Marburg, Germany

ABSTRACT

Navigation systems are commonly used in neurosurgical operating theaters. Generally, they either rely on the use of preoperative or intraoperative image data. Using preoperative image data, the phenomenon of brain shift contributes most to errors, in addition to various other sources of decreased reliability, such as image-related errors or registration inaccuracy. Updating navigation after intraoperative magnetic resonance imaging (iMRI) serves as immediate feedback on the surgical result and furthermore compensates for the effects of brain shift. Together with an integration of functional data in the navigation such as diffusion tensor imaging (DTI)−based fiber tracking or functional MRI, there is evidence that iMRI contributes to maximize extent of resection in glioma surgery with a preservation of neurological function. The following article summarizes the work flow and clinical impact of iMRI and functional navigation, as well as current problems and possible solutions.