Graphical user interfaces for simulation of brain deformation in image-guided neurosurgery

In image-guided neurosurgery, preoperative images are typically used for surgical planning and intraoperative guidance. The accuracy of preoperative images can be significantly compromised by intraoperative brain deformation. To compensate for brain shift, biomechanical finite element models have been used to assimilate intraoperative data to simulate brain deformation. The clinical feasibility of the approach strongly depends on its accuracy and efficiency. In order to facilitate and streamline data flow, we have developed graphical user interfaces (GUIs) to provide efficient image updates in the operating room (OR). The GUIs are organized in a top-down hierarchy with a main control panel that invokes and monitors a series of sub-GUIs dedicated to perform tasks involved in various aspects of computations of whole-brain deformation. These GUIs are used to segment brain, generate case-specific brain meshes, and assign and visualize case-specific boundary conditions (BC). Registration between intraoperative ultrasound (iUS) images acquired pre- and post-durotomy is also facilitated by a dedicated GUI to extract sparse displacement data used to drive a biomechanical model. Computed whole-brain deformation is then used to morph preoperative MR images (pMR) to generate a model-updated image set (i.e., uMR) for intraoperative guidance (accuracy of 1-2 mm). These task-driven GUIs have been designed to be fault-tolerant, user-friendly, and with sufficient automation. In this paper, we present the modular components of the GUIs and demonstrate the typical workflow through a clinical patient case.