Image-guided therapy and intraoperative MRI in neurosurgery

Computer-assisted 30 planning, navigation and the possibilities offered by intra-operative imaging updates have made a large impact on neurological su rgery. Three-dimensional rendering of complex medical image information, as well as co-registration of multimodal sources has reached a highly sophist icated level. When introduced into surgical navigation however, this pre-op erative data is unable to account for intra-operative changes, ('brain-shif t'). To update structural information during surgery, ari open-configured, intra-operative MRI (Signa SP, 0.5 T) was realised at our institution in 19 95. The design, advantages, limitations and current applications of this sy stem are discussed, with emphasis on the integration of imaging into proced ures. We also introduce our integrated platform for intra-operative visuali sation and navigation, the 30 Slicer.