• Vitor Mendes Pereira, Iris Smit-Ockeloen, Olivier Brina, Drazenko Babic, Marcel Breeuwer, Karl Schaller, Karl-Olof Lovblad, and Daniel Ruijters.
• *Division of Neuroradiology, Department of Medical Imaging and ‖Division of Neurosurgery, University Hospitals of Geneva, Geneva, Switzerland; ‡Division of Neuroradiology, Department of Medical Imaging and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; §Eindhoven University of Technology, Department of Biomedical Engineering, Eindhoven, the Netherlands; ¶Philips Healthcare, Best, the Netherlands.
• Neurosurgery. 2015 Aug 27.

BackgroundCerebrospinal fluid leakage and ventricular compression during open surgery may lead to brain deformation called brain shift. Brain shift may affect intraoperative navigation that is based on image-based preoperative planning. Tools to correct or predict these anatomic modifications can be important to maintain precision during open guided neurosurgery.ObjectiveTo obtain a reliable intraoperative volumetric deformation vector field describing brain shift during intracranial neurosurgical procedures.MethodsWe acquired preoperative and intraoperative cone-beam computed tomography enhanced with intravenous injection of iodine contrast. These data sets were preprocessed and elastically registered to obtain the volumetric brain shift deformation vector fields.ResultsWe obtained the brain shift deformation vector field in 9 cases. The deformation fields proved to be highly nonlinear, particularly around the ventricles. Interpatient variability was considerable, with a maximum deformation ranging from 8.1 to 26.6 mm and a standard deviation ranging from 0.9 to 4.9 mm.ConclusionContrast-enhanced cone-beam computed tomography provides a feasible technique for intraoperatively determining brain shift deformation vector fields. This technique can be used perioperatively to adjust preoperative planning and coregistration during neurosurgical procedures.AbbreviationsCBCT, cone-beam computed tomographyHU, Hounsfield units.

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