Background: Image-based scalp localization methods currently used are complex and not standardized. The authors have developed a simple yet accurate method for craniotomy localization using multiplanar reconstruction (MPR) algorithms.
Methods: In this method, the goal is to localize a projected point (defined as T) of the center of the lesion on the scalp. An oblique coronal plane is reformatted using a patient's magnetic resonance (MR) images with MPR algorithms to include both the center of the lesion and bilateral external auditory meati. Then the distance between T and the ipsilateral external auditory meatus or sagittal suture (defined as S) is measured along the scalp contour in the plane. The distance between the bregma and S is also measured. These distances are used for scalp localization, using a tape measure in the operating room.
Results: We have had successful scalp localization in six clinical cases. It took about 3 min to measure each distance on the MR console.
Conclusion: This method for craniotomy planning using MPR algorithms is simple and sufficiently accurate.