Three-Dimensional Imaging in Neurosurgical Research and Education

OBJECTIVE: We describe the setup and use of different 3-dimensional (3-D) recording modalities (macroscopic, endoscopic, and microsurgical) in our laboratory and operating room and discuss their implications in neurosurgical research and didactics. We also highlight the utility of 3-D images in providing depth perception and discernment of structures compared with 2-dimensional (2-D) images. METHODS: The technical details for equipment and laboratory setup for obtaining 3-D images were described. The stereoscopic pair of images was obtained using a modified "shoot-shift-shoot" method and later converged to a 3-D image. For microsurgical procedures, 3-D images were obtained using an integrated 3-D video camera coupled to the surgical microscope in both the laboratory and the operating room. Illustrative cases were used to compare 2-D and 3-D images. RESULTS: Side-by-side comparisons of 2-D and 3-D images obtained using all modalities revealed that 3-D imaging was superior to 2-D imaging in providing depth perception and structure identification. CONCLUSIONS: This is the first report in the literature of the methodology for obtaining 3-D endoscopic endonasal images using the 2-D endoscope. The use of 3-D imaging is invaluable in neurosurgical research and education, as it provides immediate depth perception (third dimension), allowing efficient understanding of key spatial relationships. Integration of 3-D imaging in neurosurgical residency programs may increase learning efficiency and shorten learning curves. However, use of 3-D imaging should not replace direct hands-on practice.