Abstract

BACKGROUND: Based on a prior needs-based questionnaire performed by our group, qualitative evidence suggests that neurosurgeons feel that image processing techniques can lead to safer and more effective operations. A wealth of image processing applications has been developed over the past several decades for the facilitation of improved surgical planning and image guidance including image registration, segmentation (of tumor, peri-tumoral edema and relevant structures), and diffusion tractography. Some of these tools have been successfully integrated into commercial surgical planning and neuronavigation systems, either as part of core functionality or as add-on packages. The Canadian healthcare system presents unique challenges to the integration of advanced imaging techniques into the clinical workflow. With limited resources, hospital administrators invest in medical devices that provide a balance of improvements in patient care while also proving to be cost effective. While neuronavigation itself has become standard of care, investment in additional commercially-available advanced imaging applications can be difficult to justify. METHODS: In collaboration with researchers at Robarts Research Institute, we have developed a framework for improved integration of advanced imaging protocols into the clinical workflow. RESULTS: We have devised a platform for the practical application and testing of image processing software for neurosurgical purposes. Our findings have been summarized in a schematic diagram outlining the workflow for the translation of image processing technologies to the operating room. CONCLUSIONS: We have developed a clinical framework that allows for use of essential commercial surgical planning and neuronavigation workstations, as well as concurrently taking advantage of university-level medical imaging expertise. This collaborative framework provides a backbone for knowledge translation from research to clinical realms and acts as a first step toward more standardized surgical planning and intra-operative neuronavigation.

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