Neuronavigation in interventional MR imaging. Prospective stereotaxy.
A practical MR imaging-based guidance/control methodology has been developed successfully and validated for improving the performance of stereotactic neurosurgerical procedures such as brain lesion biopsy. The use of the device and method in 40 routine MR-guided procedures has revealed its potential as an alternative approach. Superior to the traditional stereotactic systems, which rely on the old images, the new method, based on prospective guidance, can provide good and acceptable targeting accuracy in the presence of brain shift. Furthermore, the use of MR monitoring of the overall neurosurgical procedure provides another independent assurance for the success of a complicated surgery. The advantages of the new surgical guidance system and method are simple and compatible with the existing capabilities of conventional MR scanners. More importantly, it allows a more effective surgical guidance in the presence of brain shift during the typical neurosurgery. Another important advantage of the guidance method and device is the performance of a truly MR-guided neurosurgical procedure in a conventional, short bore high field MR scanner. Surgical procedures using the guidance system and method have been accepted by radiologists and neurosurgeons as an attractive MR-based stereotactic approach. It can be expected that this guidance scheme will be a useful addition to the MR-based stereotactic system for neurosurgery, and animal research, in which cumbersome stereotactic frames have been used.