Correlation of pre-operative MRI and intra-operative 3D ultrasound to measure brain tissue shift

B-Mode ultrasound is often used during neurosurgery to provide intra-operative images of the brain through a craniotomy, but the use of 3D ultrasound during surgery is still in its infancy. We have developed a system that provides real-time freehand 3D ultrasound reconstruction at a reduced resolution. The reconstruction proceeds incrementally and the 3D image is overlayed, via a computer, on a pre-operative 3D MRI scan. This provides the operator with the necessary feedback to maintain a constant freehand sweep-rate, and also ensures that the sweep covers the desired anatomical volume. All of the ultrasound video frames are buffered, and a full-resolution, compounded reconstruction proceeds once the manual sweep is complete. We have also developed tools for manual tagging of homologous landmarks in the 3D MRI and 3D ultrasound volumes that use a piecewise cubic approximation of thin-plate spline interpolation to achieve interactive nonlinear registration and warping of the MRI volume to the ultrasound volume: Each time a homologous point-pair is identified by the user, the image of the warped MRI is updated on the computer screen after less than 0.5 s.