Ultrasound Combined with Neurosurgical Navigation

The integration of the IGSonic ultrasound system, developed by BrainLAB (Munich, Germany), a developer of image-guided surgery systems, into BrainLAB's VectorVision surgical navigation system combines the benefits of two effective neurosurgical techniques into one, rendering the use of intra-operative ultrasound feasible for neurosurgeons. Up to now, neurosurgeons could only use ultrasound images with navigation by connecting an external ultrasound device.

Insufficient image quality in the past combined with a nonuser-friendly interface often limited the use of ultrasound in neurosurgery. "Ultrasound provides a 3D [three-dimensional] rendering of tumor boundaries that are not visible to the naked eye or even with a surgical microscope, and provides information about the distribution of blood vessels and the blood flow intra-operatively and in real time,” explained Dr. Warren W. Boling, assistant professor from the neurosurgical department of West Virginia University (Morgantown, WV, USA), who played a crucial role in the development of this integration, and is the first one to use the technology in the United States.

With this new integrated system, ultrasound data gathered during the operation is now displayed on the navigation system's screen. This information greatly expands on the 3D anatomy and surgical orientation data provided by image-guided surgery. The ultrasound integration enables cost-effective ways for procedures that rely on this information, such as intra-operative resection control. With the combination of high-precision imagery, the surgeon can excise tumor tissue as completely and safely as possible without damaging neighboring healthy tissue. A minimally invasive incision can also be made, while at the same time, substantially reducing the risk of having to perform additional operative procedures since tumor tissue that could possibly be left behind can easily become a new tumor.

"Before the development of the IGSonic system, the intra-operative use of ultrasound with neurosurgical navigation was too time-consuming. With the help of this new technology, we can routinely and efficiently use this technology because the ultrasound probe is joined with the VectorVision system,” explained Dr. Boling.




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