AVM-Explorer: Multi-Volume Visualization of Vascular Structures for Planning of Cerebral AVM Surgery

Arteriovenous malformations (AVMs) of the brain are rare vascular disorders characterized by the presence of direct connections between cerebral arteries and veins. Preoperative planning of AVM surgery is a challenging task. The neurosurgeon needs to gain a detailed understanding of both the pathoanatomy of the lesion as well as its location and spatial relation to critical functional areas and white matter fiber bundles at risk. A crucial element during this planning phase is the precise identification of feeding arteries, draining veins, and arteries “en passage". To this end, a variety of imaging modalities for displaying neurovascular structures exists, both tomographic as well as projection based. However, the conventional 2D slice based review of such data is not well suited to help understanding the complex angioarchitecture of an AVM. In this paper, we demonstrate how stateof-the-art techniques from the fields of computer graphics and image processing can support neurosurgeons with the challenge of creating a mental 3D model of the lesion and understanding its internal structure. To evaluate the clinical value of our method, we present results from three case studies along with the medical assessment of an experienced neurosurgeon.