2026 Projects
2026 Project: North America
Enhancing Translational Neuronavigation Capacity in Honduras
Project Team
- Ena Isabel Miller (Co-lead) Hospital Mario Catarino Rivas and Universidad Nacional
- Gabor Fichtinger (Co-lead), Queen’s University
- Víctor Berríos, MD, Hospital Mario Catarino Rivas
- Norman Cubilla, MSc, Universidad Nacional Autónoma de Honduras
- Alexandra Golby, MD, Harvard University / Brigham and Women's Hospital
- Sonia Pujol, PhD, Harvard University / Brigham and Women's Hospital
- Ron Kikinis, MD, Harvard University / Brigham and Women's Hospital
- Carla Chong Lara, MD, Hospital Mario Catarino Rivas
- Francisco Amador, MD, Hospital Hondureño de Seguridad Social
- Eduardo Nassar, MD Hospital Escuela Universitario
- Oscar Panameno, MD, Hospital Escuela Universitario
- Fabiola Cortez, MD, Hospital del Caribe, Puerto Cortés
Location
Honduras
Executive Summary
The project aims to build sustainable translational neuronavigation research and training capacity in Honduras. Our initiative responds to severe and persisting disparities in neurosurgical care across Mesoamerica, where advanced technologies, such as computer-assisted neuronavigation systems, are limited to private hospitals due to exorbitant costs. In Honduras, public hospitals lack such technology despite having experienced neurosurgeons who previously have used commercial neuronavigation systems that became unsustainably expensive to maintain. The country’s centralized healthcare system and cohesive neurosurgical community create favorable conditions for reintroducing a locally maintainable neuronavigation technology.
The project leverages NousNav (www.nousnav.org), a low-cost open source neuronavigation platform offering over 95% cost reduction compared to commercial alternatives while maintaining clinically appropriate spatial accuracy. To support hands-on practical experience and training, the project integrates NousNav with a novel hybrid simulation environment using reusable manikin-based phantoms and public de-identified MRI data. Through diffeomorphic registration, MRI volumes are morphed to the manikin’s 3D mesh to produce anatomically realistic, patient-specific models. This setup will enable complete workflow practice, from segmentation and planning to targeting, without requiring imaging scanners or expensive hardware or elaborate fabrication processes. Tests on twelve MRI datasets yielded submillimeter accuracy and rapid case generation, validating its technical feasibility.
The one-year project will proceed in four phases: (1) building local technical competence in NousNav installation and maintenance; (2) developing a modular training curriculum; (3) delivering and evaluating training for neurosurgeons and residents using structured performance and usability assessments; and (4) consolidating sustainability, preparing publications, and disseminating results through open platforms.
By combining expertise in neurosurgery, computing, engineering, training, education, and open-source software, this project addresses critical barriers to neurosurgical capacity building in low-resource settings. Drawing on the successful practices and experience of the Train the Trainers program supporting the establishment of locally sustainable centers of translational research into ultrasound-guided interventions in West Africa, we aim to foster the development of a self-sustaining community of neurosurgeons in Honduras skilled in neuronavigation while establishing a reproducible model for capacity-driven, locally led neurosurgical innovation.