Fiducial optimization for minimal target registration error in image-guided neurosurgery

Reuben R. Shamir*, Leo Joskowicz, Yigal Shoshan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


This paper presents new methods for the optimal selection of anatomical landmarks and optimal placement of fiducial markers in image-guided neurosurgery. These methods allow the surgeon to optimally plan fiducial marker locations on routine diagnostic images before preoperative imaging and to intraoperatively select the set of fiducial markers and anatomical landmarks that minimize the expected target registration error (TRE). The optimization relies on a novel empirical simulation-based TRE estimation method built on actual fiducial localization error (FLE) data. Our methods take the guesswork out of the registration process and can reduce localization error without additional imaging and hardware. Our clinical experiments on five patients who underwent brain surgery with a navigation system show that optimizing one marker location and the anatomical landmarks configuration reduced the TRE. The average TRE values using the usual fiducials setup and using the suggested method were 4.7 mm and 3.2 mm, respectively. We observed a maximum improvement of 4 mm. Reducing the target registration error has the potential to support safer and more accurate minimally invasive neurosurgical procedures.

Original languageAmerican English
Article number6095635
Pages (from-to)725-737
Number of pages13
JournalIEEE Transactions on Medical Imaging
Issue number3
StatePublished - Mar 2012

Bibliographical note

Funding Information:
Manuscript received June 24, 2011; revised November 02, 2011; accepted November 07, 2011. Date of publication December 06, 2011; date of current version March 02, 2012. This work was supported by the FP7 ERC ROBOCAST Grant 21590. Asterisk indicates corresponding author. *R. R. Shamir was with the Rachel and Selim Benin School of Engineering and Computer Science, The Hebrew University of Jerusalem, 91904 Jerusalem, Israel. He is now with the Edmond and Lily Safra Center for Brain Sciences, Medical Neurobiology and Neurosurgery Departments, The Hebrew University and Hadassah Medical Center, 91120 Jerusalem, Israel (e-mail: shamir. [email protected]).


  • Accuracy
  • image-guided neurosurgery
  • localization and tracking
  • rigid registration
  • therapy planning


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