用术前MRI预测癫痫手术中脑移位,提升导航精度
From Pre- to Intra-operative MRI: Predicting Brain Shift in Temporal Lobe Resection for Epilepsy Surgery
- 基于U-Net模型,仅凭术前MRI预测脑移位
- 局部位移误差低至1.12毫米,整体变形匹配度达0.97
- 适合神经外科医生提升手术安全与效率
在神经外科中,术前脑部磁共振成像(MRI)是图像引导手术系统(IGNS)定位手术目标和规划路径的核心依据。然而,打开硬膜后脑移位会使得术前影像失真。因此,结合脑移位补偿的术中脑部MRI对提升神经导航精度至关重要。本文提出NeuralShift——一种基于U-Net的模型,仅依赖术前MRI即可预测颞叶切除术中的脑移位。通过分析手术侧及中线解剖标志点的靶点注册误差(TRE)以及预测的术中掩码与实际术中MRI掩码的DICE分数进行评估。实验结果显示,该模型能准确预测大脑全局形变(DICE = 0.97),并实现局部位移误差低至1.12毫米,有效补偿颞叶切除过程中的大范围脑移位。结果表明,该模型可仅使用术前影像完成脑移位预测,为手术团队提供更高安全性与效率,改善患者预后。相关代码将在录用后公开于https://github.com/SurgicalDataScienceKCL/NeuralShift。
原文摘要 · Abstract (English)
Introduction: In neurosurgery, image-guided Neurosurgery Systems (IGNS) highly rely on preoperative brain magnetic resonance images (MRI) to assist surgeons in locating surgical targets and determining surgical paths. However, brain shift invalidates the preoperative MRI after dural opening. Updated intraoperative brain MRI with brain shift compensation is crucial for enhancing the precision of neuronavigation systems and ensuring the optimal outcome of surgical interventions. Methodology: We propose NeuralShift, a U-Net-based model that predicts brain shift entirely from pre-operative MRI for patients undergoing temporal lobe resection. We evaluated our results using Target Registration Errors (TREs) computed on anatomical landmarks located on the resection side and along the midline, and DICE scores comparing predicted intraoperative masks with masks derived from intraoperative MRI. Results: Our experimental results show that our model can predict the global deformation of the brain (DICE of 0.97) with accurate local displacements (achieve landmark TRE as low as 1.12 mm), compensating for large brain shifts during temporal lobe removal neurosurgery. Conclusion: Our proposed model is capable of predicting the global deformation of the brain during temporal lobe resection using only preoperative images, providing potential opportunities to the surgical team to increase safety and efficiency of neurosurgery and better outcomes to patients. Our contributions will be publicly available after acceptance in https://github.com/SurgicalDataScienceKCL/NeuralShift.
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