Elements Image Fusion PG

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Purpose

This Training Guide is based on the Image Fusion software. It documents how Image Fusion may be

used in a clinical setting, but it is not meant as a replacement to the Image Fusion Software User Guide.

For questions regarding recommended use of Brainlab equipment and/or software, always refer to the

Software User Guide as your first level of product support.

The training provided to the customer is based on the product-specific training requirements. Users must

be trained and qualified to operate the Image Fusion. Contact Brainlab Customer Support if new users

require training.

Copyright

Copyright © 2017 Brainlab. All rights reserved.

Course Information

• Released: January, 2017

• TRM 21-88, Rev. 3

Brainlab Customer Support Information

Region Telephone and Fax Email

United States, Canada, Central

and South America

Tel: (800) 597-5911

Fax: (708) 409-1619

Brazil Tel: (800) 892-1217

us.support@brainlab.com

UK Tel: +44 1223 755 333

Spain Tel: +34 627 973 272

France and French-speaking

regions

Africa, Asia, Australia, Europe

Japan

Tel: +33 800 676 030

Tel: +49 89 991568-44

Fax: +49 89 991568-811

Tel: +81 3 3769 6900

Fax: +81 3 3769 6901

support@brainlab.com

© 2017 Brainlab


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TABLE OF CONTENTS

BRAINLAB ELEMENTS IMAGE FUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Element Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Module 1: Image Fusion Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Module 2: Working with Fusion Pairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Module 3: Fusion Result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

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Overview

Image Fusion allows you to register image sets, with the same or different

modalities (CT, MR, PET, SPECT) with a minimum of two image sets. Once

two image sets are fused, they can be viewed synchronously. All planned

content (for example, objects, points and trajectories) defined in one image

set is visible in any other fused image set.

Modules

This element contains the following modules:

Module 1: Image Fusion Overview

Module 2: Working with Fusion Pairs

Module 3: Fusion Result

Element Outcomes:

Upon completion of this lesson, you will be able to:

• explain the key functions, features, and benefits of Image Fusion

• explain how Image Fusion is used in planning surgery and oncology

procedures

• describe rigid fusion for cranial and spine

• verify the fusion with the Spy Glass tool and the Blending tool

• perform cranial distortion correction

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Module 1: Image Fusion Overview

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Overview

This module provides an overview of the functionality of Image Fusion

including its features and benefits.

Module Outcome

Upon completion of this module, you will be able to:

• describe the features and benefits of Image Fusion and and how they are

used to manage images

What is Image Fusion?

Fusion is the process of merging different image sets with each other. The

fusion result is a link between several datasets generating a fusion chain.

Image Fusion merges image sets together. Images from the same or other

modalities (CT, MR, PET, SPECT) can be used, but a minimum of two images

are required. The software:

• proposes a fusion chain based on pre-defined pairing rules

• uses an algorithm to fuse the selected image sets

Image Fusion Features and Benefits

Image Fusion has many features and benefits including:

Table 1-1: Image Fusion Features and Benefits

Features

Benefits

Fusion pairs are automatically

pre-selected

Fusions are automatically

pre-calculated for all available

fusion pairs

Automatic streamlined workflow

Ease of use

Allows you to fuse image sets, with

the same or different modalities

Automated fusion calculation

NOTE

Selection is based on image modality, resolution, number of slices,

date and time, scan sequence, and image type.

NOTE

Screen navigation buttons are the same as what was covered in

previous topics.

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Module 2: Working with Fusion Pairs

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Overview

Image Fusion can be applied within different workflows. The application is

adapted for the clinical context (e.g., cranial or spine procedures) in which it

is intended to work.

Module Outcomes

Upon completion of this module, you will be able to:

• fuse image pairs for both spine and cranial images

• correct distortion in fused cranial images

• edit fusion pairs

Rigid Fusion

Inaccuracies in rigid fusion can be caused by distortion within one of the

image sets. When fusing cranial images, the fusion is automatic when the

application launches. When fusing spine images, the user must manually

initiate the fusion.

When images are fused:

• There is an automatic shift to the next unfused pair once the fusion is

accepted.

• All planned content (for example, objects, points and trajectories) defined

in one image set is visible in any other fused image set.

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Image Fusion for Cranial

Below is the workflow for Image Fusion for Cranial:

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Table 1-2: Cranial Image Fusion Workflow

Step

Action

1 Select Image Fusion.

2 Fusion calculation starts automatically when entering the

application.

3 Carefully verify the image fusion, especially in the region of interest

(ROI) in all three planes (axial, coronal, and sagittal).

4 Approve the fusion result by clicking on the check mark in the Do

you accept the result box.

5 The application automatically jumps to next unfused fusion pair or

click Next Pair.

6 Repeat steps 3-4, if necessary.

7 Click Done to exit Image Fusion. The fusion result(s) is saved for

further processing.

Cranial Distortion Correction

Inaccuracies within fusion results can still exist after manual adjustment or

choosing ROI fusion. Such inaccuracies could be a result of distortion during

image acquisition.

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Follow the workflow below to complete a cranial distortion correction:

NOTES

Table 1-3: Cranial Distortion Correction Workflow

Step

Action

1 Adjust image sets, if necessary (rare for cranial cases).

2 Calculate the distortion correction.

3 Review and verify the distortion correction.

4 Toggle between the distortion correction and the original by

clicking on the Original button.

5 Approve the fusion result by clicking on the check mark in the Do

you accept the result box.

6 Automatic shift to next unfused fusion pair.

7 Repeat steps 4-5, if necessary.

8 Click Done to exit the cranial distortion correction. The cranial

distortion is saved.

Image Fusion for Spine

Image Fusion can be done within the spine workflow. Follow the workflow

below to perform Spine Image Fusion:

Table 1-4: Spine Image Fusion Workflow

Step

Action

1 Select Image Fusion for Spine.

2 Adjust the Region of Interest (ROI).

3 Align the image sets to roughly fit within the ROI.

4 Clicking on Fusion to start the image fusion calculation.

5 Carefully verify the image fusion, especially in the region of interest

(ROI) in all the planes (axial, coronal, and sagittal) using Spy Glass

and Blending functionality.

6 Approve the fusion result by clicking on the check mark in the Do

you accept the result box.

7 Repeat steps 3-6, if necessary.

8 Click Done to exit Image Fusion for Spine. The fusion result(s) is

saved for further processing.

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NOTES

Editing Fusion Pairs

Preselected image pairs can also be edited by the user. Follow the steps in

the workflow below to edit the fusion pairs:

Table 1-5: Editing Fusion Pairs Workflow

Step

Action

1 Open the Fusions drop-down menu in the Data menu.

2 Review the fusion pairs.

3 Choose the datasets you want to fuse.

4 Click Use this Pair (Image Fusion automatically fuses the new

pair).

5 Return to the main screen to review the image fusion.

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Module 3: Fusion Result

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NOTES

Overview

It is important to verify the image fusion. There are two ways to verify the

fusion: Spy Glass and Blending. This module explains the workflows

associated with both tools.

Module Outcome

Upon completion of this module, you will be able to:

• verify the accuracy of the fusion using the Spy Glass and Blending tools

Spy Glass

Spy Glass is used to visually verify the accuracy of the image fusion by

providing an overlay of a secondary image set that can be translated over the

primary image for review. You can view the shape, size, and position of an

anatomical structure or tumor in two image sets at the same time.

Follow the steps in the workflow below when using Spy Glass:

Table 1-6: Spy Glass Workflow

Step

Action

1 Click Spy Glass on the tool bar.

2 The Spy Glass superimposes the second image set over the first

image set. The window can be positioned anywhere over the

underlying image.

3 To resize, drag the corners of the windows to the desired area and

shape.

4 Scroll through the image slices using the arrows or the mouse

wheel.

5 Zoom in or out on the main view using the Zoom tool or by

pressing Ctrl and rotating the mouse wheel.

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Blending

Blending is used to distinguish between two fused image sets. The primary

image set is blue as indicated in the upper left hand corner. The secondary,

movable, image set is amber as indicated in the upper right hand corner.

Follow the steps in the workflow below when using Blending:

Table 1-7: Blending Workflow

Step

Action

1 Select Blending and modify the blended image, by by moving the

blending slider left or right in the main viewing area on the screen.

2 • Scroll through the image slices, using the arrow buttons.

NOTE: The mouse wheel can also be used to scroll.

• Zoom in or out on the main view using the Zoom tool or by

pressing Ctrl and rotating the mouse wheel.

3 Review the fusion and press Approve Fusion if the results are

satisfactory.

4 Press Done when finished.

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Element Review

This lesson provided an overview of the Image Fusion software application,

including a product overview, the basic functions, and key features and

benefits.

NOTES

CHECK POINT

Check Point is dedicated for a quick review of this section

• What image modalities are compatible with Image Fusion?

• What is the difference between using Image Fusion for spine and using

Image Fusion for cranial?

• How do you correct cranial distortion in Image Fusion?

• What tools are used in fusion verification? How is each tool used?

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