Assessment of an image-guided neurosurgery system using a head phantom

Ballesteros-Zebadúa, Paola; García‐Garduño, Olivia Amanda; Cruz, O. O. Galván de la; Arellano-Reynoso, Alfonso; Lárraga‐Gutiérrez, José M.; Celis, Miguel Ángel

doi:10.3109/02688697.2016.1173188

Cited by 16 publications

(15 citation statements)

References 17 publications

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“…The current results are similar to those from our earlier publication (2.49 ± 1.07 mm for fiducial markers and 5.03 ± 2.30 mm for surface matching) [ 14 ]. Although, since then, a number of publications have reported relatively high accuracy of surface matching systems [ 1 , 5 , 8 , 9 , 11 ]; most of these do not compare to the use of fiducial markers, and none of these report on actual measurements in a true neurosurgical setting. Instead, they use cadaver measurements, phantom measurements, calculated estimations of accuracy or measurements in non-surgical cases such as Gamma Knife treatment.…”

Section: Discussionmentioning

confidence: 99%

Current accuracy of surface matching compared to adhesive markers in patient-to-image registration

Mongen

Willems

2019

Acta Neurochir

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Object In the past, the accuracy of surface matching has been shown to be disappointing. We aimed to determine whether this had improved over the years by assessing application accuracy of current navigation systems, using either surface matching or point-pair matching. Methods Eleven patients, scheduled for intracranial surgery, were included in this study after a power analysis had shown this small number to be sufficient. Prior to surgery, one additional fiducial marker was placed on the scalp, the “target marker,” where the entry point of surgery was to be expected. Using one of three different navigation systems, two patient-to-image registration procedures were performed: one based on surface matching and one based on point-pair matching. Each registration procedure was followed by the digitization of the target marker’s location, allowing calculation of the target registration error. If the system offered surface matching improvement, this was always used; and for the two systems that routinely offer an estimate of neuronavigation accuracy, this was also recorded. Results The error in localizing the target marker using point-pair matching or surface matching was respectively 2.49 mm and 5.35 mm, on average ( p < 0.001). In those four cases where an attempt was made to improve the surface matching, the error increased to 6.35 mm, on average. For the seven cases where the system estimated accuracy, this estimate did not correlate with target registration error ( R 2 = 0.04, p = 0.67). Conclusion The accuracy of navigation systems has not improved over the last decade, with surface matching consistently yielding errors that are twice as large as when point-pair matching with adhesive markers is used. These errors are not reliably reflected by the systems own prediction, when offered. These results are important to make an informed choice between image-to-patient registration strategies, depending on the type of surgery at hand.

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Section: Discussionmentioning

confidence: 99%

Current accuracy of surface matching compared to adhesive markers in patient-to-image registration

Mongen

Willems

2019

Acta Neurochir

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“…Registration errors of bone markers result from the discrepancy between the spatial location of the head and its spatial coordinates in the ROSA system. 1,18 The main sources of registration errors can include the following: 1) error caused by personnel manipulation, 2) image error such as image artifacts of the bone marker, 3) robot system error, and 4) physical factors caused by deformation of the object. 8,9 In fact, many variables influence the modified distance of the artifact error in the registration plan.…”

Section: Figmentioning

confidence: 99%

Improved accuracy using a modified registration method of ROSA in deep brain stimulation surgery

Feng¹,

Jin²,

Yang³

et al. 2018

Neurosurgical Focus

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OBJECTIVEThe aim of this study was to determine whether a modified registration method could reduce registration error and postoperative electrode vector error and to analyze the method’s clinical significance in deep brain stimulation (DBS) surgery.METHODSThe first part of the study involved a skull model, in which three registration methods were tested using the ROSA (robotic stereotactic assistance) system. In the second part, four registration methods were clinically tested in patients undergoing DBS surgery using the ROSA system. Thirty-three patients (65 sides, group I) underwent the conventional registration method 2E, and registration errors were recorded. Thirty-eight patients (75 sides, group II) underwent four types of modified registration methods including 2A, 2B, 2C, and 2D. Registration and electrode vector errors, intraoperative electrophysiological signal length (IESL), and DBS power-on voltage were recorded. The primary measure of efficacy was the change in the Unified Parkinson’s Disease Rating Scale (UPDRS) and UPDRS Part III scores from baseline to 10 weeks after surgery.RESULTSIn the skull model, the registration error (mean ± SD) was 0.56 ± 0.11 mm for method 1A, 0.35 ± 0.11 mm for method 1B (vs. 1A, p < 0.001), and 0.90 ± 0.15 mm for method 1C (vs. 1A, p < 0.001). In the clinical study, method 2C was selected for DBS surgery in group II since it had the smallest registration error among the four methods tested. The registration error was 0.62 ± 0.22 mm (mean ± SD) for group I and 0.27 ± 0.07 mm for group II (p < 0.001). Postoperative electrode vector error was 0.97 ± 0.31 mm for group I and 0.65 ± 0.23 mm for group II (p < 0.001). There was a positive correlation between registration error and electrode vector error in both groups (group I: r = 0.69, p < 0.001; group II: r = 0.71, p < 0.001). The mean IESL was 5.0 ± 0.9 mm in group I and 5.8 ± 0.7 mm in group II (p < 0.001). The mean DBS power-on voltage was 1.63 ± 0.44 V in group I and 1.48 ± 0.38 V in group II (p = 0.027). In the UPDRS score, group I showed 50% ± 16% improvement and group II showed 52% ± 18% improvement (p = 0.724); there was no statistically significant difference in improvement on the UPDRS.CONCLUSIONSIn DBS surgery assisted by the ROSA system, registration error and electrode vector error showed a positive correlation. The modified registration method could reduce the registration error and electrode vector error, but the long-term effects need to be further observed and evaluated.

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“…To date, some non-invasive registration tools, such as headset, skin-adhesive markers, laser surface scanning, etc., have been utilized in image-guided surgery, but these have been less accurate 32 – 39 . The main reasons for this lack of accuracy may be that these fiducial systems are not firmly connected to the skull and are far from the operation area, which affects the recognition of the navigation system.…”

Section: Discussionmentioning

confidence: 99%

Image-guided cochlear access by non-invasive registration: a cadaveric feasibility study

Wang

Liu

et al. 2020

Sci Rep

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Image-guided cochlear implant surgery is expected to reduce volume of mastoidectomy, accelerate recovery, and improve safety. The purpose of this study was to investigate the safety and effectiveness of image-guided cochlear implant surgery by a non-invasive registration method, in a cadaveric study. We developed a visual positioning frame that can utilize the maxillary dentition as a registration tool and completed the tunnels experiment on 5 cadaver specimens (8 cases in total). The accuracy of the entry point and the target point were 0.471 ± 0.276 mm and 0.671 ± 0.268 mm, respectively. The shortest distance from the margin of the tunnel to the facial nerve and the ossicular chain were 0.790 ± 0.709 mm and 1.960 ± 0.630 mm, respectively. All facial nerves, tympanic membranes, and ossicular chains were completely preserved. Using this approach, high accuracy was achieved in this preliminary study, suggesting that the non-invasive registration method can meet the accuracy requirements for cochlear implant surgery. Based on the above accuracy, we speculate that our method can also be applied to neurosurgery, orbitofacial surgery, lateral skull base surgery, and anterior skull base surgery with satisfactory accuracy.

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Assessment of an image-guided neurosurgery system using a head phantom

Cited by 16 publications

References 17 publications

Current accuracy of surface matching compared to adhesive markers in patient-to-image registration

Current accuracy of surface matching compared to adhesive markers in patient-to-image registration

Improved accuracy using a modified registration method of ROSA in deep brain stimulation surgery

Image-guided cochlear access by non-invasive registration: a cadaveric feasibility study

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