Neurology and Neurosurgery

Jan. 30, 2026

Intraoperative CT registered to preoperative imaging can greatly enhance the accuracy of surgery targeting deep brain structures. But CT scans increase radiation exposure, cost and workflow complexity.

Mayo Clinic researchers have demonstrated the feasibility of a 3D surface scanning approach. In a cadaveric study comparing standard CT-based registration and 3D surface scanning, the new system achieved accuracy equal to or better than CT while avoiding radiation exposure. The research was published in the Journal of Neurosurgery.

Key findings:

• The 3D scanning system workflow achieved a mean fiducial registration error of 0.14 millimeters (mm) — outperforming the conventional CT-based method's mean error of 0.20 mm.
• The 3D system scans the frame components and facial surface in a single pass, avoiding adhesive markers or extra scans that can be required with existing frameless navigation systems.

3D scanning systems capture high-resolution point clouds of craniofacial anatomy and frame components within seconds, enabling automatic alignment of the patient's surface geometry with preoperative imaging data. Recent progress in computational geometry and artificial intelligence has led to greater accuracy in aligning surface point clouds to volumetric CT or MR imaging.

Mayo Clinic's project combines the enterprise's engineering and surgical expertise. "When engineers and neurosurgeons look at the same challenge, we see different details. That's where breakthroughs can happen," says Jaeyun Sung, Ph.D., a computational biologist at Mayo Clinic in Rochester, Minnesota, and the study's corresponding author. "This is about building the next generation of surgical tools that bring engineering-level, submillimeter precision directly into the operating room."

The researchers note that 3D scanning can lower operating time and costs and particularly benefit centers with limited CT access. "This new 3D scanning method is safe, quick and cost-effective. It can help us hit the right target more accurately, improving how we care for patients," says Kendall H. Lee, M.D., Ph.D., a neurosurgeon at Mayo Clinic's campus in Minnesota.

The researchers are working to make the 3D scanning process faster and easier to use. They are also testing new hardware and running a larger clinical trial to further evaluate the technique's effectiveness in brain surgery.

For more information

Sharaf BA, et al. Three-dimensional surface scanning for registration in stereotactic neurosurgery: A cadaveric feasibility study. Journal of Neurosurgery. 2025;144:305.

Refer a patient to Mayo Clinic.