Optimized 3D path planner for steerable catheters with deductive reasoning

Keyhole neurosurgery is challenging, due to the complex anatomy of the brain and the inherent risk of damaging vital structures while reaching the surgical target. This paper presents a path planner for safe and effective neurosurgical interventions. The strengths of the proposed framework lay in the integration of multiple risk structures combined into a deductive method for fast and intuitive user interaction, and a modular architecture. The tool is intended to support neurosurgeons at quickly determining the most appropriate surgical trajectory through the brain matter with minimized risk; the user interface guides the user through the decision making process and helps save planning time of neurosurgical interventions. Risk structures and trajectories can be visualized in an intuitive way, thanks to a 3D brain surgery simulator developed with Unity. A qualitative evaluation with clinical experts shows the practical relevance, while a quantitative performance and functionality analysis proves the robustness and effectiveness of the system with respect to literature.