Automated atlas integration and interactive three-dimensional visualization tools for planning and guidance in functional neurosurgery

Many critical functionally distinct subcortical structures are not distingu ishable on anatomical magnetic resonance imaging (MRI) scans. In order to p rovide the neurosurgeon with this missing information, a deformable volumet ric atlas of the basal ganglia and thalamus has been created from the Schal tenbrand and Wahren atlas of cryogenic slices. The volumetric atlas can be automatically deformed to an individual patient's MRI. To facilitate the cl inical use of the atlas, a visualization platform has been developed for pr eoperative and intraoperative use which permits manipulation of the merged atlas and MRI data sets in two- and three-dimensional views, The platform i ncludes graphical tools which allow the visualization of projections of a l eukotome and other surgical tools with respect to the atlas data, as well a s preregistered images from any other imaging modality. In addition, a grap hical interface has been designed to create custom virtual lesions using co mputer models of neurosurgical tools for intraoperative planning, To date t his system has been employed as an adjunct to over 30 functional neurosurgi cal cases including surgery for movement disorders.