Nervous System Exploration Using Tractography To Enhance Pelvic Surgery
Résumé
Pelvic surgery raises the challenge of preser-
vation of nerves that handle urinary, gen-
ital and digestive functions, especially in
situations where these structures may be modi-
fied by tumors or malformations. Recent works
on 3D nerve visualization, that rely on cadavers
dissections [1, 3] or intra-operative use of probes
detecting myelin-binding fluorophores [5], do
not provide pre- or post-operative analysis of
the pelvic nervous anatomy. Magnetic reso-
nance neurography as in [12] requires a slice by
slice manual segmentation of the nerves. Dif-
fusion MRI, associated with tractography algo-
rithms, is currently the only technique allow-
ing for in-vivo exploration of the nervous net-
work [2] with no need for manual nerve segmen-
tation. In contrast to brain imaging that moti-
vated a lot of work, only few studies focus on pe-
ripheral nerves visualization [9, 10, 14]. In this
paper, we propose a method for pelvic tractog-
raphy analysis based on patient-specific organ
segmentation. It is demonstrated with promis-
ing results on a healthy adult subject.