A Systematic Review on Data-Driven Brain Deformation Modeling for Image-Guided Neurosurgery

TL;DR

This systematic review analyzes recent AI-driven methods for modeling and correcting brain deformation in image-guided neurosurgery, highlighting advances, limitations, and future research opportunities for clinical translation.

Contribution

It provides a comprehensive synthesis of methodological strategies, datasets, evaluation metrics, and validation practices in AI-based brain deformation modeling from 2020 to 2025.

Findings

AI models show promising accuracy and efficiency

Current methods lack robustness and standardization

Challenges remain in clinical deployment and interpretability

Abstract

Accurate compensation of brain deformation is a critical challenge for reliable image-guided neurosurgery, as surgical manipulation and tumor resection induce tissue motion that misaligns preoperative planning images with intraoperative anatomy and longitudinal studies. In this systematic review, we synthesize recent AI-driven approaches developed between January 2020 and April 2025 for modeling and correcting brain deformation. A comprehensive literature search was conducted in PubMed, IEEE Xplore, Scopus, and Web of Science, with predefined inclusion and exclusion criteria focused on computational methods applied to brain deformation compensation for neurosurgical imaging, resulting in 41 studies meeting these criteria. We provide a unified analysis of methodological strategies, including deep learning-based image registration, direct deformation field regression, synthesis-driven multimodal alignment, resection-aware architectures addressing missing correspondences, and hybrid models that integrate biomechanical priors. We also examine dataset utilization, reported evaluation metrics, validation protocols, and how uncertainty and generalization have been assessed across studies. While AI-based deformation models demonstrate promising performance and computational efficiency, current approaches exhibit limitations in out-of-distribution robustness, standardized benchmarking, interpretability, and readiness for clinical deployment. Our review highlights these gaps and outlines opportunities for future research aimed at achieving more robust, generalizable, and clinically translatable deformation compensation solutions for neurosurgical guidance. By organizing recent advances and critically evaluating evaluation practices, this work provides a comprehensive foundation for researchers and clinicians engaged in developing and applying AI-based brain deformation methods.