On the value of multi-volume visualization for preoperative planning of cerebral AVM surgery

Surgical treatment of cerebral arteriovenous malformations (AVMs) requires thourough preoperative planning for the intervening neurosurgeon. The goal of such planning is to gain a precise understanding of the patho-anatomy of the malformation, specifically about the location and spatial relation of normal and abnormal structures. A key element in this process is the identication and localization of arteries feeding into the lesion, and veins draining it. In this paper, we demonstrate how state-of-the-art techniques from the field of computer graphics and image processing can support neurosurgeons with this task. We address the problem by merging multiple angiographic image sets within a 3D volume rendering pipeline. Datasets from clinical imaging studies were remotely processed at our institute, returned to the institution of origin, and finally visualized in an interactive application, allowing the neurosurgeon to explore the different images simultaneously. Here, we present three case studies along with the medical assessment of an experienced neurosurgeon.