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Additional info for Advanced techniques in image-guided brain and spine surgery
The outer cranial surface). In pulse echo ultrasound, a short pulse of energy is transmitted into the body. Echoes in the received signal represent sound reflected at interfaces between regions of different acoustic impedance. 7 for bone–tissue interfaces. Thus echoes corresponding to bone–tissue interfaces have high signal amplitude and are easily identified. The distance from the transducer to the interface corresponding to an echo is easily calculated as d = ut/2, where d is the distance, u is the speed of sound, and t is the time interval between the initial sound pulse and the received echo.
Skin-affixed markers (multimodality radiographic markers, IZI Medical Products, Baltimore, MD) on a patient. (B–D). 13 The image markers are constructed from hollow plastic cylinders that are filled with an aqueous solution of iothalamate meglumine and gadopentetate dimeglumine and sealed (B, left; C). The physical space markers (localization caps) are manufactured with a hemispherical divot whose position corresponds to the centroid of the image markers (B, right; D). The threaded ends of plastic marker bases or posts (B, center) are screwed into the outer table of the skull of the patient.
Examples of important image acquisition factors are field of view, voxel dimensions (especially slice thickness), and considerations that impact geometric fidelity. For CT this might include performing a spiral scan to minimize patient movement during image acquisition; for MR this might include using specific pulse sequences that minimize geometrical distortion due to static field inhomogeneity. Surface-based registration techniques are currently used in several commercially available IGS systems for IPR.