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Biomedical subjects

N Hern

Publications and source records attributed to N Hern.

4 recordsLinked to original sources

Planning and simulation of neurosurgery in a virtual reality environment.

OBJECTIVE: To report our experience with preoperative neurosurgical planning in our stereoscopic virtual reality environment for 21 patients with intra- and extra-axial brain tumors and vascular malformations. METHODS: A neurosurgical planning system called VIVIAN (Virtual Intracranial Visualization and Navigation) was developed for the Dextroscope, a virtual reality environment in which the operator reaches with both hands behind a mirror into a computer-generated stereoscopic three-dimensional (3-D) object and moves and manipulates the object in real time with natural 3-D hand movements. Patient-specific data sets from multiple imaging techniques (magnetic resonance imaging, magnetic resonance angiography, magnetic resonance venography, and computed tomography) were coregistered, fused, and displayed as a stereoscopic 3-D object. A suite of 3-D tools accessible inside the VIVIAN workspace enabled users to coregister data, perform segmentation, obtain measurements, and simulate intraoperative viewpoints and the removal of bone and soft tissue. RESULTS: VIVIAN was used to plan neurosurgical procedures primarily in difficult-to-access areas, such as the cranial base and the deep brain. The intraoperative and virtual reality 3-D scenarios correlated well. The VIVIAN system substantially contributed to surgical planning by 1) providing a quick and better understanding of intracranial anatomic and abnormal spatial relationships, 2) simulating the craniotomy and the required cranial base bone work, and 3) simulating intraoperative views. CONCLUSION: The VIVIAN system allows users to work with complex imaging data in a fast, comprehensive, and intuitive manner. The 3-D interaction of this virtual reality environment is essential to the efficient assembly of surgically relevant spatial information from the data derived from multiple imaging techniques. The usefulness of the system is highly dependent on the accurate coregistration of the data and the real-time speed of the interaction.

Adult↗

Planning of skull base surgery in the virtual workbench: clinical experiences.

Based on the KRDL Virtual Workbench, we present a neurosurgical planning system called VIVIAN (Virtual Intracranial Visualization And Navigation). This VR environment allows for fast and intuitive interaction with three-dimensional multimodal (MRI, MRA, MRV, CT) patient specific data-sets. The user reaches behind a mirror into a 3D workspace where the 3D data is surrounded by interactive virtual tools-racks. Tumors, blood vessels, cranial nerves and surgically relevant parts of the brain are segmented by interactive control of density transfer-functions or by manual outlining and tracing tools. A neurosurgical procedure is planned by using various visualization and measurement tools and the system allows for the simulation of bone drilling and tissue removal. We have planned 16 cases which required tumor surgery at the cranial base. VIVIAN provided an efficient and comprehensive way to understand pre-operatively the complexity of anatomical and pathological relationships. The ideal craniotomy and the extent of the required skull base exposure could be specified accurately.

Computer Simulation↗

An interface for precise and comfortable 3D work with volumetric medical datasets.

We have developed a 3D/2D paradigm of interaction that combines manipulation of precise 3D volumetric data with unambiguous widget interaction. Precise 3D interaction is ensured by a combination of resting the lower arms on an armrest and pivoting the hands around the wrist. Unambiguous 2D interaction is achieved by providing passive haptic feedback by means of a virtual control panel whose position coincides with the physical surfaces encasing the system. We have tested this interface with a neurosurgical planning application that has been clinically used for 17 skull-base cases at two local hospitals.

Computer Simulation↗

The Brain Bench: virtual tools for stereotactic frame neurosurgery.

We present a suite of neurosurgery supporting tools developed around (i) the Virtual Workbench, a productive environment for the control of 3-D data, in which delicate work can be performed for hours on end without strain, and (ii) the Electronic Brain Atlas, integrating the major print brain atlases in day-to-day clinical use. We describe in detail the Brain Bench, a surgical planning system for stereotactic frame neurosurgery. Its objective is to prepare faster plans; have a better and more accurate choice of target points; improve the avoidance of sensitive structures; have fewer sub-optimal frame attachments and speedier, more effective planning and training. If validated by a clinical study now under way, this will improve medical efficacy and reduce costs.

Brain↗