The main goal of image guidance in neurosurgery is to accurately project magnetic resonance imaging (MRI) and/or computed tomography (CT) data into the operative field for defining anatomical landmarks, pathological structures and margins oftumors. To achieve this, "neuronavigation" software solutions have been developed to provide precise spatial information to neurosurgeons. Safe and accurate navigation of brain anatomy is of great importance when attempting to avoid important structures such as arteries and nerves.

Neuronavigation software provides orientation information to the surgeon during all three phases of surgery: 1) pre-operative trajectory planning, 2) the intraoperative steroetactic procedure, and 3) post-operative visualization. Trajectory planning is performed prior to surgery using preoperative MRI data. On the day of surgery, the plans are transferred to sterotactic space using a frame or frame-less system. In both instances, a set of radiopaque fiducials are detected, providing the transformation matrix from anatomical space to sterotactic space. During the surgical procedure, the plans are updated according to intraoperative data collected (i.e. microelectrode recordings, electrode stimulation etc.). After the surgery, post-operative MRI or CT imaging confirms the actual position of the trajectory(ies).

## trajectoryGuide?¶

trajectoryGuide is a surgical planning, visuazliation, and postoperative assessment tool used for various trajectory surguries. It provides capabilities across the entire surgical spectrum:

## What is 3D Slicer?¶

3D Slicer is an open-source software platform for medical image informatics, image processing, and 3D visualization. Built over two decades through support from the National Institutes of Health and a worldwide developer community, Slicer brings free, powerful cross-platform (Linux, MacOSX, and Windows) processing tools to physicians, researchers, and the general public.

### 3D Slicer Features¶

Multi-organ: from head to toe Support for multi-modality imaging including: MRI, CT, US, nuclear medicine, and microscopy Bidirectional interface for devices

## Sources¶

• https://slicer.org
• https://www.slicer.org/wiki/Main_Page
• Fedorov A., Beichel R., Kalpathy-Cramer J., Finet J., Fillion-Robin J-C., Pujol S., Bauer C., Jennings D., Fennessy F., Sonka M., Buatti J., Aylward S.R., Miller J.V., Pieper S., Kikinis R. 3D Slicer as an Image Computing Platform for the Quantitative Imaging Network <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466397/>_. Magnetic Resonance Imaging. 2012 Nov;30(9):1323-41. PMID: 22770690.