Initial experience with an ultrasound-integrated single-rack neuronavigation system

A prototype ultrasound-integrated neuronavigation system was tested in 34 o perations as regards image quality, stability, and handling during daily us e in the operating theatre. The system consists of a high-end ultrasound sc anner. a navigation Computer, and an active optical positioning and digitis er system, all integrated in a single rack. An Ethernet interface between t he two hardware devices enables digital data transfer between the ultrasoun d scanner and the navigation device without loss of image quality. The integration of an ultrasound scanner and a navigation device offers the opportunity of navigating directly to an intracranial or intraspinal lesio n using intra-operative 3D ultrasound images. The brainshift problem is thu s avoided. The ability to directly compare MR images and 3D ultrasound simp lifies the interpretation of ultrasound images. The single-rack solution is an advantage in times of restricted space in the operating theatre caused by the increasing volume of technical equipment needed for a neurosurgical operation. In 30 cases the prototype system showed good reliability. In four cases the navigation system failed during the operations however, the capacity of th e ultrasound scanner was still available as a stand-alone function. With th e single-rack concept. the flexibility of the system is high and the comple te device can easily be moved from one operating theatre to another.