Elisee Ilunga-Mbuyamba

Intraoperative ultrasound (iUS) imaging is commonly used to support brain tumor operation. The tumor segmentation in the iUS images is a difficult task and still under improvement because of the low signal-to-noise ratio. The success of automatic methods is also limited due to the high noise sensibility. Therefore, an alternative brain tumor segmentation method in 3D-iUS data using a tumor model obtained from magnetic resonance (MR) data for local MR–iUS registration is presented in this paper. The aim is to enhance the visualization of the brain tumor contours in iUS.

Intraoperative ultrasound (iUS) imaging is routinely performed to assist neurosurgeons during tumor surgery. In particular, the identification of the possible presence of residual tumors at the end of the intervention is crucial for the operation outcome. B-mode ultrasound remains the standard modality because it depicts brain structures well. However, tumorous tissue is hard to differentiate from resection cavity borders, blood and artifacts. On the other hand, contrast enhanced ultrasound (CEUS) highlights residuals of the tumor, but the interpretation of the image is complex. Therefore, an assistance system to support the identification of tumor remnants in the iUS data is needed. Our approach is based on image segmentation and data fusion techniques. It consists of combining relevant information, automatically extracted from both intraoperative B-mode and CEUS image data, according to decision rules that model the analysis process of neurosurgeons to interpret the iUS data. The method was tested on an image dataset of 23 patients suffering from glioblastoma. The detection rate of brain areas with tumor residuals reached by the algorithm was qualitatively and quantitatively compared with manual annotations provided by experts. The results showed that the assistance tool was able to successfully identify areas with suspicious tissue.