Modularity (Workflow)
Stereotactic planning is very usable for arc-based head-frames in case of skull surgeries like DBS electrode placement, brain biopsy, brachytherapy treatment of brain tumors or in special cases of thermo-coagulation. The most important system elements, in case of neurosurgical interventions are:
- Head-frame selection: Riechert-Mundinger, MHT and their adaptations as well as Leksell and CRW frames;
- Patient-based database support for multimodality images which are automatically recognized and parsed by extracting DICOM header parameters. Archived plans for surgeries are also parsed for organizing surgical data with diagnostics;
- Diagnostic image processing (anatomical fitting or resampling of reference images; image fusion between CT-MR modalities and pre- or post-operative diagnostics);
- Modular („workflow-based”) surgical planning software;
- Storing of archived surgical plan with diagnostic data and loading, redisplaying it for post-operative consultation.
Surgical planning implemented by CranioPass has modular design, which built into the diagnostic data preparation and stereotactic target localization as well. During diagnostic data preparation 3 active modules can be selected implicitly in this order:
- Patient Data (database access);
- CT-MR Fusion;
- 3D Planning (orthographic and fusioned slice views);
Other modules are under development and made unactive, not usable in this version (tractographic analysis in relation to diffusion MR, DWI data and frameless navigation functionalities): MR-DWI (Diffusion Weihted Image) Fusion – Traktography – Navigation).
On selecting “3D Planning” module, the computations of parameters needed for adjustment of stereotactic frame can be carried out according to anatomical criteria or by taking into account other, neurosurgeon preferred aspects. CranioPass supported interventions:
- Calculation of path for DBS electrode;
- Stereotactic planning for pallidotomy/thalamotomy surgeries;
- Target and trajectory planning for brachytherapy radiation;
- Trajectory planning for brain biopsy;
Optional Design
CranioPass design is able to visualize targeted brain areas on multimodal (fusioned) diagnostic background and to project into stereotactic space of different arc-based head-frames. The planning platform is strictly 3D based, easily adaptable to different stereotactic head frames, the planning steps are organized in modular form and contain real time error estimation with continuous update on graphic display.
Patient Database
After starting, CranioPass reconstructs and visualizes a patient database according to a hierarchial tree structure. The “root” folder contains the list of hierarchically organized files for patients’ (DICOM/NIFTI) diagnostics and archived planning studies (.vts files). The user can select a particular diagnostics for a patient and investigate parameters of imaging or display elements of surgical planning stored in archived study file.
Image 3. View of patient database. Diagnostic image sequences and study files (.vts) can be assigned to elements of patient’s list. The parameters of selected item (stored in DICOM header) are listed in parsing (information) window (bottom). This simplifies the communication with radiologic departments or CT-MR laboratories for complex interventions.
CranioPass
CranioPassCranioPassCranioPass
CranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPassCranioPass