Abstract
Workflows for MRI-guided minimally-invasive neurosurgeries are often time-consuming and complex. Many minimally-invasive interventions utilize magnetic resonance imaging (MRI) to noninvasively visualize internal anatomy and pathologies. This, in conjunction with external trajectory guides, can be used to internally position devices to perform complex surgeries with minimal disruption to the patients’ healthy anatomy.
These trajectory guides are typically rigidly attached to the skull and feature adjustable channels through which drills, needles, and /or catheters may be introduced. Trajectories are oriented by iterating between imaging and manipulation of device settings. MRI scans, while offering a great deal of valuable anatomic information, are slow to acquire. Scans of a sufficient resolution for neurosurgery can take on the order of 10 minutes to acquire, depending on field of view. Noniterative approaches could reduce complexity and anesthesia time.
This work describes efforts to create and validate a new trajectory guide that enables faster, accurate trajectory guidance in minimally-invasive neurosurgeries. Using new hardware and software, a single scan approach was used to perform drill guidance and device insertion on phantoms and cadaver heads.
The proposed methodology accurately guided needles to targets within phantoms and human cadaver brains using a single targeting scan. The initial design produced a radial error of 1.4±0.8mm in phantoms and 1.5±0.8mm in cadaver brains.
The proposed device and software accelerate trajectory guidance in minimally-invasive neurosurgeries by reducing the number of acquired scans and procedural steps. This in turn minimizes time under anesthesia.
