Toward Accurate and Accessible Markerless Neuronavigation

Neuronavigation is widely used in biomedical research and interventions to guide the precise placement of instruments around the head to support procedures such as transcranial magnetic stimulation. Traditional systems, however, rely on subject-mounted markers that require manual registration, may shift during procedures, and can cause discomfort. We introduce and evaluate markerless approaches that replace expensive hardware and physical markers with low-cost visible and infrared light cameras incorporating stereo and depth sensing combined with algorithmic modeling of the facial geometry. Validation with $50$ human subjects yielded a median tracking discrepancy of only $2.32$ mm and $2.01°$ for the best markerless algorithms compared to a conventional marker-based system, which indicates sufficient accuracy for transcranial magnetic stimulation and a substantial improvement over prior markerless results. The results suggest that integration of the data from the various camera sensors can improve the overall accuracy further. The proposed markerless neuronavigation methods can reduce setup cost and complexity, improve patient comfort, and expand access to neuronavigation in clinical and research settings.