Interactive 3-D graphics workstations in stereotaxy: clinical requirements, algorithms, and solutions

In stereotactic treatment planning the spatial relationships between a variety of objects has to be taken into account in order to avoid destruction of vital brain structures and rupture of vasculature. The visualization of these highly complex relations may be supported by 3-D computer graphics methods. In this context the three-dimensional display of the intracranial vascular tree and additional objects, such as neuroanatomy, pathology, stereotactic devices, or isodose surfaces, is of high clinical value. We report an advanced rendering method for a depth-enhanced maximum intensity projection from magnetic resonance angiography (MRA) and a walk-through approach to the analysis of MRA volume data. Furthermore, various methods for a multiple-object 3-D rendering in stereotaxy are discussed. The development of advanced applications in medical imaging can hardly be successful if image acquisition problems are disregarded. We put particular emphasis on the use of conventional MRI and MRA for stereotactic guidance. The problem of MR distortion is discussed and a novel three- dimensional approach to the quantification and correction of the distortion patterns is presented. Our results suggest that the sole use of MR for stereotactic guidance is highly practical. The true three-dimensionality of the acquired datasets opens up new perspectives to stereotactic treatment planning. For the first time it is possible now to integrate all the necessary information into 3-D scenes, thus enabling an interactive 3-D planning.