Full-field MRIMeasurements of in-vivo Positional Brain Shift Reveal the Significance of Intra-cranial Geometry and Head Orientation for Stereotactic Surgery

Full-field MRI Measurements of in-vivo Positional Brain Shift Reveal the Significance of Intra-cranial Geometry and Head Orientation for Stereotactic Surgery | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Full-field MRI Measurements of in-vivo Positional Brain Shift Reveal the Significance of Intra-cranial Geometry and Head Orientation for Stereotactic Surgery Stefano Zappalà, Nicholas J. Bennion, Matthew R. Potts, Jing Wu, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-542215/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Positional brain shift (PBS), the sagging of the brain under the effect of gravity, is comparable in magnitude to the margin of error for the success of stereotactic interventions (∼1 mm). This non-uniform shift due to slight differences in head orientation can lead to a significant discrepancy between the planned and the actual location of surgical targets. Accurate in vivo measurements of this complex deformation are critical for the design and validation of an appropriate compensation to integrate into neuronavigational systems. PBS arising from prone-to-supine change of head orientation was measured with magnetic resonance imaging on 11 young adults. The full-field displacement was extracted on a voxel-basis via digital volume correlation and analysed in a standard reference space. Results showed the need for target-specific correction of surgical targets, as a significant displacement ranging from 0.52 mm to 0.77 mm was measured at surgically relevant structures. Strain analysis further revealed local variability in compressibility: anterior regions showed expansion (both volume and shape change), whereas posterior regions showed small compression, mostly dominated by shape change. Finally, analysis of correlation demonstrated the potential for further patient-and intervention-specific adjustments, as intra-cranial breadth and head tilt correlated with PBS reaching statistical significance. Bioinformatics Positional brain shift stereotactic interventions target-specific correction PBS reaching statistical significance Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Full-Text Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF. Additional Declarations Competing interest reported. SE worked on several projects funded by Renishaw plc. All other authors declare no potential conflict of interest. Supplementary Files SupplementaryDiscussion.pdf Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revision 19 Jul, 2021 Reviews received at journal 07 Jul, 2021 Reviewers agreed at journal 23 Jun, 2021 Reviews received at journal 21 Jun, 2021 Reviewers agreed at journal 21 Jun, 2021 Reviewers invited by journal 16 Jun, 2021 Editor assigned by journal 06 Jun, 2021 Editor invited by journal 24 May, 2021 Submission checks completed at journal 21 May, 2021 First submitted to journal 20 May, 2021 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-542215","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":28465038,"identity":"ea6233bd-7b3b-4838-8899-689e6bd87ef7","order_by":0,"name":"Stefano Zappalà","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIie3RMYvCMBTA8VcCdXmQ9YmiX+EdgY72qyiCLr1DcBEO1M1FcFXwQwiCs1Jol7o71sUpHMItDh1sdSu0OjrkvwRCfiSPAJhMH9sAQGYrckM+d/avCANUpw+iHut7hLNDCG+Q5uwYxDduuSr0L1c9YIKKHwuMiok1/+l/zbnb2UU9tVpzSrDHAk/FRIDnELJoOydQAjkZA3gg8FpMbKmdasITVy0r/ylJb5G6nCB5Tg3ZtzaE6kkou6XkYUR/fVXnsLOMvKGVzWLThQ/rkvGbi+/grEe/rpyFW9AJk5Tdc6yDYpI+zc5NBy8/Mk9MJpPJlO8OWehFyvCdDGgAAAAASUVORK5CYII=","orcid":"","institution":"Cardiff University","correspondingAuthor":true,"prefix":"","firstName":"Stefano","middleName":"","lastName":"Zappalà","suffix":""},{"id":28465039,"identity":"4566b502-de65-4b20-9257-2e219a2caba1","order_by":1,"name":"Nicholas J. 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On the left, greater values of azimuth angle represent head of the participant turned right during scanning. On the right, higher values of elevation angle represent head of the participant tilted downwards during scanning. The shape of the skull from the MNI atlas is overlapped as reference for the neutral head orientation.","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/2afa962a60530e097e6de10e.jpg"},{"id":9727903,"identity":"dae4389a-141a-4304-93e6-1769964003aa","added_by":"auto","created_at":"2021-05-28 19:31:40","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":122859,"visible":true,"origin":"","legend":"Vector plots of PBS for two axial (a and b) and two sagittal (c and d) slices. Length of vectors have been scaled for visualisation purposes: their magnitude is represented by the underlying contour plots. As reference, dashed coloured lines\nrepresent the position of the other slices. In particular, slice a was positioned at the level of the anterior and posterior horns of the lateral ventricles, whereas slice c was positioned at the level of the falx cerebri.","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/180dc43ebb17d9674110a53f.jpg"},{"id":9728286,"identity":"13bdd1ca-f82d-485f-a9ef-efb8f6f86989","added_by":"auto","created_at":"2021-05-28 19:34:40","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":62921,"visible":true,"origin":"","legend":"please see the manuscript file for the full caption","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/ab8d8691bb6139f06e54069f.jpg"},{"id":9728288,"identity":"ef0a0b27-9c05-4414-861d-212d6dcbf81f","added_by":"auto","created_at":"2021-05-28 19:34:40","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":62253,"visible":true,"origin":"","legend":"please see the manuscript file for the full caption","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/1c4d170779d3ef93ec60549c.jpg"},{"id":9728284,"identity":"83a08187-2769-41be-9793-b9fe8d7f6aee","added_by":"auto","created_at":"2021-05-28 19:34:40","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":56097,"visible":true,"origin":"","legend":"please see the manuscript file for the full caption","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/989593d7b95c36c989c5419b.jpg"},{"id":9727909,"identity":"86e12ce8-069a-4225-b2a2-6a9b1c6f4904","added_by":"auto","created_at":"2021-05-28 19:31:40","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":46663,"visible":true,"origin":"","legend":"Diagonal components of strain averaged over some ROI: left (L) and right (R) anterior and posterior meninges (Men Ant, Men Post), frontal lobe (Front), temporal lobe (Temp), ventricles (Vent), parietal lobe (Par), occipital lobe (Occ).\nBlue lines represent the overall diagonal component (whiskers representing inter-subject variability), whereas the orange and yellow lines its deviatoric and volumetric components.","description":"","filename":"6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/7d4979401b35b6c25da881ca.jpg"},{"id":9728665,"identity":"02328a1d-df96-4e9c-887e-1db06eb4024e","added_by":"auto","created_at":"2021-05-28 19:37:40","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":60530,"visible":true,"origin":"","legend":"Scatter plots of the correlation between PBS and MCB. Azimuth (blue dots) and elevation (orange squares) angles are reported on the left against values of MCB, whereas against magnitude of PBS on the right. As reference, linear fit is superimposed to the data.","description":"","filename":"7.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/3da4fb15005d0105a492b823.jpg"},{"id":9728666,"identity":"c779549c-2e36-4991-a159-3db5c6513869","added_by":"auto","created_at":"2021-05-28 19:37:40","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":61340,"visible":true,"origin":"","legend":"Scatter plots of the correlation between PBS and gravity ( ¯ g). Elevation angle of gravity is here reported against elevation angle (left) and against magnitude of PBS (right) for both prone (blue dots) and supine (orange squares) positioning. As reference, linear fit is superimposed to the data in the case of the statistical correlation between elevation angle of ¯ g in supine and both elevation angle (on the left) and magnitude (on the right) of PBS.","description":"","filename":"8.jpg","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/12958da6a0d77012161a4e18.jpg"},{"id":13637193,"identity":"647d09d4-e59c-4d5e-8a57-81b1c81099b2","added_by":"auto","created_at":"2021-09-17 08:44:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2292663,"visible":true,"origin":"","legend":"","description":"","filename":"ArticleFile.pdf","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1_covered.pdf"},{"id":9728685,"identity":"30bc78d2-c683-4edc-ae40-ea5018230089","added_by":"auto","created_at":"2021-05-28 19:37:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2288988,"visible":true,"origin":"","legend":"","description":"","filename":"ArticleFile.pdf","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1_covered.pdf"},{"id":9727910,"identity":"572d8e35-2dd0-472f-8c81-de1ef3a26edc","added_by":"auto","created_at":"2021-05-28 19:31:40","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":2937768,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryDiscussion.pdf","url":"https://assets-eu.researchsquare.com/files/rs-542215/v1/118dde4b84148cdbced14351.pdf"}],"financialInterests":"Competing interest reported. SE worked on several projects funded by Renishaw plc. All other authors declare no potential conflict of interest.","formattedTitle":"\u003cp\u003eFull-field MRI Measurements of in-vivo Positional Brain Shift Reveal the Significance of Intra-cranial Geometry and Head Orientation for Stereotactic Surgery\u003c/p\u003e","fulltext":[{"header":"Full-Text","content":"\u003cp\u003eDue to technical limitations, full-text HTML conversion of this manuscript could not be completed. 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This non-uniform shift due to slight differences in head orientation can lead to a significant discrepancy between the planned and the actual location of surgical targets. Accurate in vivo measurements of this complex deformation are critical for the design and validation of an appropriate compensation to integrate into neuronavigational systems. PBS arising from prone-to-supine change of head orientation was measured with magnetic resonance imaging on 11 young adults. The full-field displacement was extracted on a voxel-basis via digital volume correlation and analysed in a standard reference space. Results showed the need for target-specific correction of surgical targets, as a significant displacement ranging from 0.52 mm to 0.77 mm was measured at surgically relevant structures. 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Finally, analysis of correlation demonstrated the potential for further patient-and intervention-specific adjustments, as intra-cranial breadth and head tilt correlated with PBS reaching statistical significance.\u003c/p\u003e","manuscriptTitle":"Full-field MRI Measurements of in-vivo Positional Brain Shift Reveal the Significance of Intra-cranial Geometry and Head Orientation for Stereotactic Surgery","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-05-28 19:31:38","doi":"10.21203/rs.3.rs-542215/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2021-07-19T06:35:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-07-07T16:06:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"e3de7b62-e910-4ac9-8d8d-a64d7ab8d761","date":"2021-06-23T12:54:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-06-22T02:50:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"ea363468-053e-49af-8f01-133fe5b33977","date":"2021-06-21T09:02:34+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2021-06-16T15:21:20+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2021-06-06T16:36:13+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2021-05-24T06:23:57+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2021-05-21T15:03:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2021-05-20T08:57:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fbb675f6-5fec-4f4d-9a7b-03c09482bdc4","owner":[],"postedDate":"May 28th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":4754005,"name":"Bioinformatics"}],"tags":[],"updatedAt":"2021-08-13T04:59:04+00:00","versionOfRecord":[],"versionCreatedAt":"2021-05-28 19:31:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-542215","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-542215","identity":"rs-542215","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}