Enhanced Reality For Neurosurgical Guidance

P. L. Gleason, R. Kikinis, W. Wells, W. Lorensen, M. S. , H. Cline, G. Ettinger, Peter McL. Black, E. Alexander III, F. Jolesz

Localization of tumors in brain surgery is one of the most challenging aspects of the field. The poor tolerance of surrounding normal tissue to disruption necessitates accurate and precise targeting. In difficult cases involving small or deep tumors localization has traditionally been achieved using a stereolactic frame rigidly fixed to the patient’s skull. We have developed an enhanced reality technique that simplifies tumor localization in brain surgerys. The technique involves merging three dimensional (3D) computer reconstructed preoperative medical scans with live peri-operative video images of patients. This image fusion combines the information from the pre-operative study with the operative field in a medium readily accessible to surgeons. In contrast to "virtual reality" in which the operator is immersed in a 3D computer graphics world, "enhanced reality" visually combines the spatial information contained in the computer reconstructions with the readily perceived world, enhancing the surgeon’s understanding of the patient’s anatomy. The background and details of this technique, along with its problems and future possibilities will be discussed.

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