Integrating electrophysiological data into an image-guided surgery system

Image-guided neurosurgery (IGNS), in which anatomical images generated from patient MRI or CT scans provide surgical guidance, is now routinely employed in numerous institutions. However, IGNS systems generally lack the ability to display functional data, a significant shortcoming for many types of procedures. We have enhanced the IGNS system used at our institution (the ISG viewing wand) allowing the surgeon to display and interact with patient electroencephalography (EEG) data in the operating room. The surgeon can: determine 3D electrode locations; display electrode locations with respect to the underlying 3D patient anatomy obtained from MRI; visualize the EEG potential field map interpolated onto the scalp; graphically analyze the time evolution of these maps; and view the location of equivalent sources within the patient cerebral structures. Display of EEG information is clinically significant in cases involving the surgical treatment of epilepsy, where EEG data plays an important role in characterizing and localizing epileptic foci, both preoperatively and during the operation.