Journal
MEDICAL IMAGE ANALYSIS
Volume 13, Issue 4, Pages 673-678Publisher
ELSEVIER
DOI: 10.1016/j.media.2009.04.001
Keywords
Brain shift; Elastic properties; Soft tissue characterization; Inverse finite element; Aspiration; Pipette
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The brain deformation that occurs during neurosurgery is a serious issue impacting the patient safety as well as the invasiveness of the brain surgery. Model-driven compensation is a realistic and efficient solution to solve this problem. However, a vital issue is the lack of reliable and easily obtainable patient-specific mechanical characteristics of the brain which, according to clinicians' experience, can vary considerably. We designed an aspiration device that is able to meet the very rigorous sterilization and handling process imposed during surgery, and especially neurosurgery. The device, which has no electronic component, is simple, light and can be considered as an ancillary instrument. The deformation of the aspirated tissue is imaged via a mirror using an external camera. This paper describes the experimental setup as well as its use during a specific neurosurgery. The experimental data was used to calibrate a continuous model. We show that we were able to extract an in vivo constitutive law of the brain elasticity: thus for the first time, measurements are carried out per-operatively on the patient, just before the resection of the brain parenchyma. This paper discloses the results of a difficult experiment and provide for the first time in vivo data on human brain elasticity. The results point out the softness as well as the highly non-linear behavior of the brain tissue. (C) 2009 Elsevier B.V. All rights reserved.
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