Displacement estimation with co-registered ultrasound for image guided neurosurgery: a quantitative in vivo porcine study

Brain shift during open cranial surgery presents a challenge for maintaining registration with image-guidance systems. Ultrasound (US) is a convenient intraoperative imaging modality that may be a useful tool in detecting tissue shift and updating preoperative images based on intraoperative measurements of brain deformation. We have quantitatively evaluated the ability of spatially tracked freehand US to detect displacement of implanted markers in a series of three in vivo porcine experiments, where both US and computed tomography (CT) image acquisitions were obtained before and after deforming the brain. Marker displacements ranged from 0.5 to 8.5 mm. Comparisons between CT and US measurements showed a mean target localization error of 1.5 mm, and a mean vector error for displacement of 1.1 mm. Mean error in the magnitude of displacement was 0.6 mm. For one of the animals studied, the US data was used in conjunction with a biomechanical model to nonrigidly re-register a baseline CT to the deformed brain. The mean error between the actual and deformed CT´s was found to be on average 1.2 and 1.9 mm at the marker locations depending on the extent of the deformation induced. These findings indicate the potential accuracy in coregistered freehand US displacement tracking in brain tissue and suggest that the resulting information can be used to drive a modeling re-registration strategy to comparable levels of agreement.