Effects of coregistration of MR of CT images on MR stereotactic accuracy

• Published in: Journal of neurosurgery Vol. 82; no. 5; pp. 772 - 779
• Main Authors: COHEN, D. S, LUSTGARTEN, J. H, MILLER, E, KHANDJI, A. G, GOODMAN, R. R
• Format: Journal Article
• Language: English
• Published: Park Ridge, IL American Association of Neurological Surgeons 01-05-1995
• Subjects: Biological and medical sciences; Brain - diagnostic imaging; Brain - pathology; Humans; Image Processing, Computer-Assisted; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Models, Structural; Nervous system; Prostheses and Implants; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Stereotaxic Techniques; Tomography, X-Ray Computed; User-Computer Interface; Performance evaluation; Human; Treatment; Radiodiagnosis; Surgery; Stereotaxic surgery; Computerized axial tomography; Nuclear magnetic resonance imaging; Comparative study; Brain (vertebrata)
• ISSN: 0022-3085; 1933-0693
• DOI: 10.3171/jns.1995.82.5.0772

Coregistration of different modality imaging serves to increase the ease and accuracy of stereotactic procedures. In many cases, magnetic resonance (MR) stereotaxis is supplanting computerized tomography (CT). The advantages of increased anatomical detail and multiplanar imaging afforded by MR, however, are offset by its potential inaccuracy as well as the more cumbersome and less available nature of its hardware. A system has been developed by one of the authors by which MR imaging can be performed separately without a stereotactic fiducial headring. Then, immediately prior to surgery, a stereotactic CT scan is obtained and software is used to coregister CT and MR images anatomically by matching cranial landmarks in the two scans. The authors examined this system in six patients as well as with the use of a lucite phantom. After initially coregistering CT and MR images, six separate anatomical (for the patients) and eight artificial (for the phantom) targets were compared. With coregistration, in comparison to CT fiducial scans, errors in each axis are less than or equal to 1 mm using the Cosman-Roberts-Wells system. In fact, the coregistered images are more accurate than MR fiducial images, in the anteroposterior (p = 0.001), lateral (p < 0.05), and vertical (p < 0.03) planes. Three-dimensional error was significantly less in the coregistered scans than the MR fiducial images (p < 0.005). The coregistration procedure therefore not only increases the case of MR stereotaxis but also increases its accuracy.