Prediction of patient orientation with minimized lateral shift for brain tumor resection therapies
Coffey, Aaron Michael
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2010-04-17
Abstract
This work demonstrates a predictive tool to aid neurosurgeons in planning tumor resection therapies by finding the optimal patient orientation that minimizes lateral brain shift in the field of view. Such orientations facilitate tumor access and removal, can reduce the need for retraction, and minimize the impact of brain shift on image guided procedures. In this study, high resolution preoperative magnetic resonance images were utilized in conjunction with pre- and post-resection laser range scans of the craniotomy to produce patient specific finite element models for 6 cases. The cases included 2 large frontal lobe tumors, 3 temporal lobe tumors, and 1 temporal-parietal tumor. General rules for applying resection and modifying model parameters were developed that were consistent with minimal shift within operating room data. In addition, an objective function is introduced to determine patient presentation such that the impact brain shift is minimized. A comparison of the optimal patient presentations as determined by the model-driven objective function to the surgical presentations selected to be optimal by our practicing neurosurgeon [RCT] is performed for 6 cases and demonstrated differences in head rotation angles ranging on average of 8.2°-13.2° and head tilt angles ranging on average 14.7° - 24.4°.