An Integrated Visualization System for Surgical Planning and Guidance Using Image Fusion and Interventional Imaging

David T. Gering, Arya Nabavi, Ron Kikinis, W. Eric L. Grimson, Nobuhiko Hata, Peter Everett, Ferenc A. Jolesz, William M. Wells III

Abstract: We present a software package which uniquely integrates several facets of image-guided medicine into a single portable, extendable environment. It provides capabilities for automatic registration, semi-automatic segmentation, 3D surface model generation, 3D visualization, and quantitative analysis of various medical scans. We describe its system architecture, wide range of applications, and novel integration with an interventional Magnetic Resonance (MR) scanner to augment intra-operative imaging with pre-operative data. Analysis previously reserved for pre-operative data can now be applied to exploring the anatomical changes as the surgery progresses. Surgical instruments are tracked and used to drive the location of reformatted slices. Real-time scans are visualized as slices in the same 3D view along with the pre-operative slices and surface models. The system has been applied in over 20 neurosurgical cases at Brigham and Women’s Hospital, and continues to be routinely used for 1-3 cases per week.