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International Journal of Computer Assisted Radiology and Surgery
Published in: International Journal of Computer Assisted Radiology and Surgery 3/2016

01-03-2016 | Original Article

Laser-assisted flat-detector CT-guided intracranial access

Authors: Daniel L. Cooke, Michael R. Levitt, Louis J. Kim, Danial K. Hallam, Laligam N. Sekhar, Basavaraj V. Ghodke

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 3/2016

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Abstract

Purpose

Flat-detector CT can be integrated with C-arm fluoroscopy for CT-guided neurosurgical and endovascular procedures. We studied the accuracy of this technique with laser assistance in targeting intracranial lesions in a cranial model.

Methods

An acrylic scale-model skull containing foam parenchyma was embedded with 2.16-mm-diameter targets. A flat-detector CT was acquired and registered to the skull’s position. Ten targets were accessed with biopsy needles under fluoroscopic guidance, flat-detector CT overlay, and laser assistance. Accuracy was measured from the needle tip to the target center using flat-detector CT.

Results

Ten targets were accessed successfully using XperGuide software. Needles were placed within 1.30 \(\pm \) 0.63 mm of target isocenter. Accuracy did not vary by entry site, operator, location, or lesion depth.

Conclusions

Laser-assisted flat-detector CT-guided targeting of all intracranial targets was successful with excellent accuracy. This technique can be applied to other minimally invasive neurosurgical procedures.
Literature
1.
Braak SJ, van Strijen MJ, van Es HW, Nievelstein RA, van Heesewijk JP (2011) Effective dose during needle interventions: cone-beam CT guidance compared with conventional CT guidance. J Vasc Interv Radiol 22:455–461CrossRefPubMed
2.
Brommeland T, Hennig R (2000) A new procedure for frameless computer navigated stereotaxy. Acta Neurochir (Wien) 142:443–447 (discussion 447–448)CrossRef
3.
Brommeland T, Hennig R (2000) Mechanical accuracy of a new stereotactic guide. Acta Neurochir (Wien) 142:449–454CrossRef
4.
Cooke DL, Levitt M, Kim LJ, Hallam DK, Ghodke B (2010) Intraorbital access using fluoroscopic flat panel detector CT navigation and three-dimensional MRI overlay. J NeuroInterv Surg 2:249–251CrossRefPubMed
5.
Cooke DL, Levitt M, Kim LJ, Hallam DK, Ghodke B (2011) Transcranial access using fluoroscopic flat panel detector CT navigation. AJNR Am J Neuroradiol 32:E69–E70CrossRefPubMed
6.
Daly M, Siewerdsen J, Moseley D, Jaffray D, Irish J (2006) Intraoperative cone-beam CT for guidance of head and neck surgery: assessment of dose and image quality using a C-arm prototype. Med Phys 33:3767–3780CrossRefPubMed
7.
Damet J, Sans-Merce M, Miéville F, Becker M, Poletti PA, Verdun FR, Baechler S (2010) Comparison of organ doses and image quality between CT and flat panel XperCT scans in wrist and inner ear examinations. Radiat Prot Dosimetry 139:164–168CrossRefPubMed
8.
Doelken M, Struffert T, Richter G, Engelhorn T, Nimsky C, Ganslandt O, Hammen T, Doerfler A (2008) Flat-panel detector volumetric CT for visualization of subarachnoid hemorrhage and ventricles: preliminary results compared to conventional CT. Neuroradiology 50:517–523CrossRefPubMed
9.
Heran N, Song J, Namba K, Smith W, Niimi Y, Berenstein A (2006) The utility of DynaCT in neuroendovascular procedures. AJNR Am J Neuroradiol 27:330–332PubMed
10.
Kettenbach J, Kara L, Toporek G, Fuerst M, Kronreif G (2014) A robotic needle-positioning and guidance system for CT-guided puncture: Ex vivo results. Minim Invasive Ther Allied Technol 23:271–278CrossRefPubMed
11.
Kim I, Son B, Lee S, Sung J, Hong J (2007) Comparison of frame-based and frameless stereotactic hematoma puncture and subsequent fibrinolytic therapy for the treatment of supratentorial deep seated spontaneous intracerebral hemorrhage. Minim Invasive Neurosurg 50:86–90CrossRefPubMed
12.
Levitt MR, Vaidya SS, Su DK, Moe KS, Kim LJ, Sekhar LN, Hallam DK, Ghodke BV (2013) The riple-overlay technique for percutaneous diagnosis and treatment of lesions of the head and neck: combined three-dimensional guidance with magnetic resonance imaging, cone-beam computed tomography, and fluoroscopy. World Neurosurg 79:509–514CrossRefPubMed
13.
Li Q, Zamorano L, Pandya A, Perez R, Gong J, Diaz F (2002) The application accuracy of the NeuroMate robot-A quantitative comparison with frameless and frame-based surgical localization systems. Comput Aided Surg 7:90–98CrossRefPubMed
14.
Miracle AC, Mukherji SK (2009) Conebeam CT of the head and neck, part 1: physical principles. AJNR Am J Neuroradiol 30:1088–1095CrossRefPubMed
15.
Nesbit GM, Nesbit EG, Hamilton BE (2011) Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors. J Neurointerv Surg 3:186–190CrossRefPubMed
16.
Nett B, Aagaard-Kienitz B, Serarslan Y, Başkaya M, Chen G (2010) A simple technique for interventional tool placement combining fluoroscopy with interventional computed tomography on a C-arm system. Neurosurgery 67:49–56 (discussion 56–47)CrossRef
17.
Paleologos T, Dorward N, Wadley J, Thomas D (2014) Clinical validation of true frameless stereotactic biopsy: analysis of the first 125 consecutive cases. Neurosurgery 49:830–835 (discussion 835–837)
18.
Quiñones-Hinojosa A, Ware M, Sanai N, McDermott M (2006) Assessment of image guided accuracy in a skull model: comparison of frameless stereotaxy techniques vs. frame-based localization. J Neurooncol 76:65–70CrossRefPubMed
19.
Racadio J, Babic D, Homan R, Rampton J, Patel M, Johnson N (2007) Live 3D guidance in the interventional radiology suite. AJR Am J Roentgenol 189:W357–W364CrossRefPubMed
20.
Ringel F, Ingerl D, Ott S, Meyer B (2009) VarioGuide: a new frameless image-guided stereotactic system–accuracy study and clinical assessment. Neurosurgery 64:365–371 (discussion 371–363)PubMed
21.
Spelle L, Ruijters D, Babic D, Homan R, Mielekamp P, Guillermic J, Moret J (2009) First clinical experience in applying XperGuide in embolization of jugular paragangliomas by direct intratumoral puncture. Int J Comput Assist Radiol Surg 4:527–533CrossRefPubMed
22.
Söderman M, Babic D, Holmin S, Andersson T (2008) Brain imaging with a flat detector C-arm : technique and clinical interest of XperCT. Neuroradiology 50:863–868CrossRefPubMed
23.
Tam A, Mohamed A, Pfister M, Chinndurai P, Rohm E, Hall A, Wallace MJ (2010) C-arm cone beam computed tomography needle path overlay for fluoroscopic guided vertebroplasty. Spine (Phila Pa 1976) 35:1095–1099
24.
Wang C, Nguyen G, Toncheva G, Jiang X, Ferrell A, Smith T, Yoshizumi T (2014) Evaluation of patient effective dose of neurovascular imaging protocols for C-arm cone-beam CT. AJR Am J Roentgenol 202:1072–1077CrossRefPubMed
25.
Widmann G, Eisner W, Kovacs P, Fiegele T, Ortler M, Lang TB, Stoffner R, Bale R (2008) Accuracy and clinical use of a novel aiming device for frameless stereotactic brain biopsy. Minim Invasive Neurosurg 51:361–369CrossRefPubMed
26.
Widmann G, Stoffner R, Sieb M, Bale R (2009) Target registration and target positioning errors in computer-assisted neurosurgery: proposal for a standardized reporting of error assessment. Int J Med Robot 5:355–365CrossRefPubMed
27.
Willems P, Noordmans H, Ramos L, Taphoorn M, Berkelbach van der Sprenkel J, Viergever M, Tulleken CA (2003) Clinical evaluation of stereotactic brain biopsies with an MKM-mounted instrument holder. Acta Neurochir (Wien) 145:889–897 (discussion 897)
28.
Yang Z, Hong B, Jia Z, Chen J, Ge J, Han J, Beilner J, Zhang Y, Fang Y, Liu J (2014) Treatment of supratentorial spontaneous intracerebral hemorrhage using image-guided minimally invasive surgery: Initial experiences of a flat detector CT-based puncture planning and navigation system in the angiographic suite. AJNR Am J Neuroradiol 35:2170–2175CrossRefPubMed
Metadata
Title
Laser-assisted flat-detector CT-guided intracranial access
Authors
Daniel L. Cooke
Michael R. Levitt
Louis J. Kim
Danial K. Hallam
Laligam N. Sekhar
Basavaraj V. Ghodke
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 3/2016
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-015-1271-5

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