Picture courtesy of
VectorVision® Cranial from BrainLab -
One form of 3-D image-guidance systems
Note: This is a similar system to the one used by Dr. Francel, but not the same one shown here
Before 3-D image-guidance systems were available, neurosurgeons would have to make a large incision and create a generous window into the skull to improve their chances of finding and removing the tumor. With 3-D image-guidance, the patient's MRI scan is downloaded into a computer system in the OR, and these images are linked to a navigation wand. When the surgeon touches the wand to the patient's head at the time of surgery, a point appears on the MRI, indicating the prescise location of the wand on the head. This allows a kind of X-ray vision. With this wand, the incision and the bone flap can be centered directly over the tumor, allowing for the smallest possible opening.
Once the neurosurgeon starts to remove the tumor, the wand can be used again to point inside the brain, within the tumor, in order to gauge how far he or she has gone. With certain types of tumors, it can be difficult to tell exactly where the tumor ends and the brain begins. The MRI may present these margins more distinctly. The description of the 3-D image-guidance system is from the book, Another Day in the Frontal Lobe by Dr. Katrina Firlik, Neurosurgeon.