Application of intraoperative computed tomography in a neurosurgical operating theatre

Gasiński, Piotr; Zieliński, Piotr; Harat, Marek; Furtak, Jacek; Rakowska, Józefina; Pa̧czkowski, Dariusz

doi:10.5114/ninp.2012.32176

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…40 With the improvement in detectors since, investigation still continues 24 as well as some very interesting work using cone-beam CT (CBCT) technology in surgery. 79 iCT continues to lack soft-tissue contrast, and radiation concerns leave its role somewhat narrower at this time.…”

Section: Intraoperative Conventional Imagingmentioning

confidence: 99%

Computational Modeling for Enhancing Soft Tissue Image Guided Surgery: An Application in Neurosurgery

Miga

2015

Ann Biomed Eng

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With the recent advances in computing, the opportunities to translate computational models to more integrated roles in patient treatment are expanding at an exciting rate. One area of considerable development has been directed towards correcting soft tissue deformation within image guided neurosurgery applications. This review captures the efforts that have been undertaken towards enhancing neuronavigation by the integration of soft tissue biomechanical models, imaging and sensing technologies, and algorithmic developments. In addition, the review speaks to the evolving role of modeling frameworks within surgery and concludes with some future directions beyond neurosurgical applications.

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Section: Intraoperative Conventional Imagingmentioning

confidence: 99%

Computational Modeling for Enhancing Soft Tissue Image Guided Surgery: An Application in Neurosurgery

Miga

2015

Ann Biomed Eng

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“…Another important factor is completeness of resection. Thus, intraoperative imaging has been introduced in the past using intraoperative computed tomography (CT)[1819] or intraoperative magnetic resonance tomography (MRT). [202122]…”

Section: Introductionmentioning

confidence: 99%

The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

Linsler

Antes

Senger

et al. 2016

Journal of Neurosciences in Rural Practice

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Objective:The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood.Materials and Methods:We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated. In this case, we performed an endonasal transsphenoidal approach for debulking the adenoma and for chiasma decompression. We used an MRI neuronavigation (Medtronic Stealth Air System) which was registered via intraoperative CT scan (Siemens CT Somatom). Preexisting MRI studies (navigation protocol) were fused with the intraoperative CT scans to enable three-dimensional navigation based on MR and CT imaging data. Intraoperatively, we did a further CT scan for resection control.Results:The intraoperative accuracy of the neuronavigation was excellent. There was an adjustment of <1 mm. The navigation was very helpful for orientation on the destroyed skull base in the sphenoid sinus. After opening the sellar region and tumor debulking, we did a CT scan for resection control because the extent of resection was not credible evaluable in this huge infiltrating adenoma. Thereby, we were able to demonstrate a sufficient decompression of the chiasma and complete resection of the medial part of the adenoma in the intraoperative CT images.Conclusions:The use of intraoperative CT/MRI-guided neuronavigation for transsphenoidal surgery is a time-effective, safe, and technically beneficial technique for special cases.

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“…While methods using iMR, 3,4 intraoperative computed tomography (iCT), 5 and intraoperative ultrasound imaging 6,7 are being pursued for providing direct imaging data by conventional modalities to facilitate soft tissue changes, other approaches are in development. These approaches use data from intraoperative microscopes, 8,9 laser range scanners, 10,11 and conoscopic holography devices 12 in conjunction with advanced modelbased image-to-physical registration approaches to compensate for deformations.…”

Section: Introductionmentioning

confidence: 99%

“…If the neurosurgeon is unsatisfied with any of the parameters of this region after finalization (size, shape, and location), he or she can use (4), (9), (10), and (12) to plan the craniotomy region again, and perform craniotomy (5) to finalize the new plan (Fig. 2).…”

mentioning

confidence: 99%

Android application for determining surgical variables in brain-tumor resection procedures

et al. 2017

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Abstract. The fidelity of image-guided neurosurgical procedures is often compromised due to the mechanical deformations that occur during surgery. In recent work, a framework was developed to predict the extent of this brain shift in brain-tumor resection procedures. The approach uses preoperatively determined surgical variables to predict brain shift and then subsequently corrects the patient's preoperative image volume to more closely match the intraoperative state of the patient's brain. However, a clinical workflow difficulty with the execution of this framework is the preoperative acquisition of surgical variables. To simplify and expedite this process, an Android, Java-based application was developed for tablets to provide neurosurgeons with the ability to manipulate three-dimensional models of the patient's neuroanatomy and determine an expected head orientation, craniotomy size and location, and trajectory to be taken into the tumor. These variables can then be exported for use as inputs to the biomechanical model associated with the correction framework. A multisurgeon, multicase mock trial was conducted to compare the accuracy of the virtual plan to that of a mock physical surgery. It was concluded that the Android application was an accurate, efficient, and timely method for planning surgical variables.

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Application of intraoperative computed tomography in a neurosurgical operating theatre

Abstract: Intraoperative CT is a very useful tool in spine surgery as well as in functional neurosurgery and neurooncology.

Cited by 10 publications

References 6 publications

Computational Modeling for Enhancing Soft Tissue Image Guided Surgery: An Application in Neurosurgery

Computational Modeling for Enhancing Soft Tissue Image Guided Surgery: An Application in Neurosurgery

The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

Android application for determining surgical variables in brain-tumor resection procedures

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