• Daniela Kuhnt, Miriam H A Bauer, and Christopher Nimsky.
• Department of Neurosurgery, University of Marburg, Germany. kuhntd@med.uni-marburg.de
• Crit Rev Biomed Eng. 2012 Jan 1;40(3):175-85.

AbstractNavigation systems are commonly used in neurosurgical operating theaters. Generally, they either rely on the use of preoperative or intraoperative image data. Using preoperative image data, the phenomenon of brain shift contributes most to errors, in addition to various other sources of decreased reliability, such as image-related errors or registration inaccuracy. Updating navigation after intraoperative magnetic resonance imaging (iMRI) serves as immediate feedback on the surgical result and furthermore compensates for the effects of brain shift. Together with an integration of functional data in the navigation such as diffusion tensor imaging (DTI)-based fiber tracking or functional MRI, there is evidence that iMRI contributes to maximize extent of resection in glioma surgery with a preservation of neurological function. The following article summarizes the work flow and clinical impact of iMRI and functional navigation, as well as current problems and possible solutions.

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