Optical Tracking Method Identifies Target Areas in Robot-Assisted Neurosurgery

While most patients respond to medication, about 30% require more advanced intervention. A key presurgical tool is stereo-electroencephalography (SEEG), which pinpoints the exact brain regions where hard-to-treat seizures begin so clinicians can determine whether targeted tissue destruction or surgical removal would be both effective and safe.

Of late, robot-assisted mapping and neurosurgery have improved the procedure’s accuracy and efficiency. Conventional mapping involves using the contact bone-fiducial registration (CBR) method, which places metal implants in the skull as reference points and maps the entry point and target areas using appropriate software. Now, a team of researchers has demonstrated the clinical utility of a novel contactless technique for use in robot-assisted neurosurgery of epileptic patients.

Researchers at Huazhong University of Science and Technology (HUST, Wuhan, China) have shown that a new contactless optical-tracking registration (OTR) method can streamline SEEG planning without sacrificing accuracy. Their findings, published in the Chinese Neurosurgical Journal, compare OTR to the traditional CBR method used during robot-assisted SEEG.

Mapping experiments on phantom heads and Bama pigs showed that OTR achieved the same precision as CBR at both target and entry points. Importantly, OTR required significantly less time than the conventional approach. Unlike CBR, which relies on implanted metal fiducials and frequent physical contact, the OTR system tracks reference markers by detecting intersecting light patterns, greatly simplifying workflow.

Learning-curve analysis revealed that new operators needed about half as many attempts to reach accurate mapping using OTR, highlighting its accessibility for clinical teams. According to the researchers, this contactless approach reduces procedural burden, streamlines SEEG planning, and improves patient comfort. The team has now initiated a multicenter clinical trial involving 50 patients with refractory epilepsy to validate the technology in human surgeries.

“If a registration method can simplify the procedure, take less time, and shorten the learning curve of the operator while maintaining accuracy, it will be of great practical importance for the clinical treatment process,” said Professor Kai Shu, who led the research team.

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