Acta Neurochirurgica (2025) 167:124
This paper discusses brainshift correction in glioma surgery using navigated intraoperative ultrasound (iUS) and MRI (iUS-MR fusion). It highlights the accuracy and practical benefits of iUS in correcting brainshift, improving neuronavigation accuracy, and aiding intraoperative decisions, especially near critical brain structures.
• Brainshift (BS) can significantly impact the accuracy of neuronavigation systems during intraoperative procedures, particularly in brain tumor surgeries.
• Rigid image fusion (RIF) using intraoperative ultrasound (iUS) and MRI is a cost-effective method to correct BS and enhance surgical accuracy.
• Factors contributing to BS include physical, surgical, and biological elements, leading to both linear and complex elastic shifts.
• iUS can be repeatedly used during surgery, offering real-time updates and corrections, thus serving as an independent tool for resection control.
• Challenges with iUS include the need for careful registration and the difficulty in correcting non-linear deformations.
• Case study: A successful application of iUS-MR fusion in a glioma surgery demonstrated improved tumor margin assessment and preservation of critical structures.
• Future advancements in automation and technology are required to address the limitations of current BS correction methods.
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