Properties of the target registration error for surface matching in neuronavigation.

OBJECTIVE: Surface matching is a relatively new method of spatial registration in neuronavigation. Compared to the traditional point matching method, surface matching does not use fiducial markers that must be fixed to the surface of the head before image scanning, and therefore does not require an image acquisition specifically dedicated for navigation purposes. However, surface matching is not widely used clinically, mainly because there is still insufficient knowledge about its application accuracy. This study aimed to explore the properties of the Target Registration Error (TRE) of surface matching in neuronavigation. MATERIALS AND METHODS: The surface matching process was simulated in the image space of a neuronavigation system so that the TRE could be calculated at any point in that space. For each registration, two point clouds were generated to represent the surface extracted from preoperative images (PC(image)) and the surface obtained intraoperatively by laser scanning (PC(laser)). The properties of the TRE were studied by performing multiple registrations with PC(laser) point clouds at different positions and generated by adding different types of error. RESULTS: For each registration, the TRE had a minimal value at a point in the image space, and the iso-valued surface of the TRE was approximately ellipsoid with smaller TRE on the inner surfaces. The position of the point with minimal TRE and the shape of the iso-valued surface were highly random across different registrations, and the surface registration error between the two point clouds was irrelevant to the TRE at a specific point. The overall TRE tended to increase with the increase in errors in PC(laser), and a larger PC(laser) made it less sensitive to these errors. With the introduction of errors in PC(laser), the points with minimal TRE tended to be concentrated in the anterior and inferior part of the head. CONCLUSION: The results indicate that the alignment between the two surfaces could not provide reliable information about the registration accuracy at an arbitrary target point. However, according to the spatial distribution of the target registration error of a single registration, enough application accuracy could be guaranteed by proper visual verification after registration. In addition, surface matching tends to achieve high accuracy in the inferior and anterior part of the head, and a relatively large scanning area is preferable.

Classification and analysis of the errors in neuronavigation.

There are many different types of errors in neuronavigation, and the reasons and results of these errors are complex. For a neurosurgeon using the neuronavigation system, it is important to have a clear understanding of when an error may occur, what the magnitude of it is, and how to avoid it or reduce its influence on the final application accuracy. In this article, we classify all the errors into 2 groups according to the working principle of neuronavigation systems. The first group contains the errors caused by the differences between the anatomic structures in the images and that of the real patient, and the second group contains the errors occurring in transforming the position of surgical tools from the patient space to the image space. Each group is further divided into 2 subgroups. We discuss 16 types of errors and classify each of them into one of the subgroups. The classification and analysis of these errors should help neurosurgeons understand the power and limits of neuronavigation systems and use them more properly.

Redefinition of hypervariable region I in mitochondrial DNA control region and comparing its diversity among various ethnic groups.

The hypervariable region I (HVR-I) of the mitochondrial DNA control region described in the literature is variable in its 5'and 3' ends as well as in its length, causing a problem when data from different ethnic groups are to be compared. To redefine HVR-I, which should be highly polymorphic yet relatively short in length, we analyzed 1437 reported sequences distributed among 11 geographic areas in the world. The results showed that the 237-bp (nts 16126-16362) redefined HVR-I (rHVR-I) had a global genetic diversity of 0.9905 and the 154-bp (nts 16209-16362) short HVR-I (sHVR-I) had a global diversity of 0.9735. Being flanked by a stretch of highly conservative sequences, both rHVR-I and sHVR-I can be produced by PCR, even if extracted from badly degraded specimens. Comparing the genetic diversity among 3870 sequences from 25 countries, we found that the genetic diversity of rHVR-I was 0.9869+/-0.0133 in Asian countries, 0.9685+/-0.0193 in African countries, 0.9299+/-0.0664 in European countries, and 0.8477+/-0.1857 in American countries, whereas that of sHVR-I was 0.9689+/-0.0284 in Asian countries, 0.9504+/-0.0334 in African countries, 0.8721+/-0.0911 in European countries, and 0.8230+/-0.1693 in American countries. The difference in genetic diversity among these countries is consistent with the notion that genetic diversity roughly reflects the genetic history of a given ethnic group. Our results indicate that a polymorphic, short, and PCR-producible HVR-I can be defined, making the comparison among various ethnic groups possible.

Cloning of genes expressed in cell quiescence: a new function of the ras-recision/lysyl oxidase gene.

The mechanism governing cell quiescence remains to be elucidated, albeit some tumor suppressor genes are known to be involved in this process. If more genes belonging to this regulatory circuit are identified, we will have a better understanding on cell quiescence. For this purpose, the present study was designed to clone genes preferentially expressed in cell quiescence. Using the method of differential display, we cloned ras-recision gene (rrg), also known as lysyl oxidase gene (lox), from BALB/c 3T3T cells, which were rendered quiescent by serum deprivation. Northern blot analysis showed that the induction of rrg/lox gene could be detected as early as 12 h following serum deprivation and it was dramatically elevated from 24 hours on after serum starvation. Induction of rrg/lox was also observed in cells rendered quiescent by contact inhibition, indicating that rrg/lox is induced by cell quiescence in general rather than specific to serum deprivation. Because rrg/lox gene products are known to be involved in extracellular matrix maturation, and function as tumor suppressors against ras oncogene, our finding suggests that quiescence-associated cell physiology is partly mediated by induction of rrg/lox.

Incidence of gastrointestinal stromal tumor: a retrospective study based on immunohistochemical and mutational analyses.

The aim of this study is to estimate the incidence of the gastrointestinal stromal tumor after the previous diagnoses were confirmed and/or revised by both immunohistochemical and mutational analyses. We reviewed 17,858 surgically excised gastrointestinal lesions in our hospital from 1998 to 2004. All mesenchymal tumors were examined for CD117 expression by immunohistochemistry, and every CD117-negative mesenchymal tumors were further subjected to mutational analysis for KIT and PDGFRA exons. The results showed that approximately 35% of gastrointestinal stromal tumors were misdiagnosed if immunohistochemical analysis of CD117 expression was not performed; and approximately 15% misdiagnosed if mutation analysis was not available. Because approximately 4.72% of patients with gastrointestinal malignancies in Taiwan were treated in our hospital and the average of newly diagnosed gastrointestinal stromal tumors in our hospital was 14.33 cases per year, the estimated annual incidents of gastrointestinal stromal tumor in Taiwan were 303.60. Therefore, the annual incidence of gastrointestinal stromal tumor is 13.74 per million Taiwanese.