Improving workflows of neuro-interventional procedures with autostereoscopic 3D visualization of multi-modality imaging in hybrid interventional suites

Perháč, Ján; Spaltenstein, Joël; Pereira, Vítor Mendes; Schaller, Karl; Brina, Olivier; Cabrilo, Ivan; Ratib, Osman

doi:10.1007/s11548-015-1268-0

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…1,2 Advancements in imaging technology have paved the way for the integration of cone-beam computed tomography (CBCT) allowing advanced navigation. [3][4][5][6] This cutting edge technique offers high-resolution imaging capabilities, enabling precise catheter placement for targeted delivery of therapeutic agents while minimizing the potential for nontargeted treatment. [7][8][9][10] Moreover, CBCT holds promise in mitigating radiation exposure for patients.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors

Cornelis,

Lis,

Tabar

et al. 2024

J Neurol Surg B Skull Base

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Purpose To assess the feasibility and safety of cone-beam computed tomography (CBCT) advanced navigation for optimizing intra-arterial chemotherapy infusion (IACI) in patients with skull base tumors. Materials and Methods Retrospective review on 10 consecutive IACI procedures performed in five patients (four women, 1 man) over a 1-year period. The median age of the patients was 71 years (interquartile range: 34–74). During the procedures, a CBCT-based navigation software was employed to evaluate tumor perfusion and guide the infusion methods. Catheterization of the primary tumor feeding vessel was performed in seven cases when it originated from the external carotid artery, whereas a temporary balloon-assisted occlusion technique was utilized in the remaining three cases where the tumor was primarily fed by the internal carotid artery. Carboplatin, topotecan, and melphalan were injected over a 10-minute period. Fluoroscopy time, reference dose, and Kerma area product, which estimates effective dose, were analyzed. Results The technical success rate was 100%, with a median procedure length of 82 minutes (79–90). The median fluoroscopy time was 11.3 minutes (9.4–16.9), reference dose was 93.5 mGy (62–256.5), and Kerma area product was 11.6 Gy.cm2 (9.5–25.4). The median effective dose was 3.8 mSv (1.5–5.1). The median follow-up duration was 233.5 days (186.3–432). One severe adverse event was reported, involving a right brachial hematoma and brachiocephalic artery dissection related to catheterization through a type III aortic arch. Three patients exhibited disease progression, but two patients showed stable disease. Conclusion IACI for skull base tumors guided by CBCT navigation is both feasible and safe.

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Section: Introductionmentioning

confidence: 99%

Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors

Cornelis,

Lis,

Tabar

et al. 2024

J Neurol Surg B Skull Base

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“…By contrast, OsiriX is an open-source Digital Imaging and Communications in Medicine (DICOM) viewer with the powerful capability of 3D volumetric rendering. OsiriX has gained significant attention in recent years as a tool of research in neurosurgery;[ 2 9 10 11 12 13 19 20 22 23 24 26 ] however, its capabilities as a preoperative planning tool are yet to be studied.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, OsiriX software has received more and more applications in vascular neurosurgery. [ 10 12 20 24 25 26 ] Using either MRI angiography (TOF sequence) or CTA, the surgeon can easily isolate only the intracranial vessels and rotate the aneurysm in every possible direction to see the full morphology of the aneurysm from every possible angle in 3D. With MRI angiography, this result is made possible simply by changing the layers (pressing ⌥ (option key) + left mouse click).…”

Section: Introductionmentioning

confidence: 99%

OsiriX software as a preoperative planning tool in cranial neurosurgery: A step-by-step guide for neurosurgical residents

Spiriev¹,

Nakov²,

Laleva³

et al. 2017

Surg Neurol Int

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Background:OsiriX (Pixmeo, Switzerland) is an open-source Digital Imaging and Communications in Medicine (DICOM) viewer that is gaining more and more attention in the neurosurgical community because of its user-friendly interface, powerful three-dimensional (3D) volumetric rendering capabilities, and various options for data integration. This paper presents in detail the use of OsiriX software as a preoperative planning tool in cranial neurosurgery.Methods:In January 2013, OsiriX software was introduced into our clinical practice as a preoperative planning tool. Its capabilities are being evaluated on an ongoing basis in routine elective cranial cases.Results:The program has proven to be highly effective at volumetrically representing data from radiological examinations in 3D. Among its benefits in preoperative planning are simulating the position and exact location of the lesion in 3D, tailoring the skin incision and craniotomy bone flap, enhancing the representation of normal and pathological anatomy, and aiding in planning the reconstruction of the affected area.Conclusion:OsiriX is a useful tool for preoperative planning and visualization in neurosurgery. The software greatly facilitates the surgeon's understanding of the relationship between normal and pathological anatomy and can be used as a teaching tool.

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“…It is claimed and now widely recognized that it could enhance catheterization abilities and reduce extra contrast administration and procedural time, especially in complex vascular catheterizations. [7][8][9][10] The use of such fusion imaging techniques is also gaining acceptance in the interventional neuroradiology field for intracranial use, [11][12][13] especially for primary access (navigation of the guiding catheter or long introducer sheath) either through venous 14 or arterial approaches. 15 The goal of our study was to assess the feasibility and evaluate the spatial accuracy of aortic arch and supra-aortic cervical vessel catheterization by means of fusion guidance using VesselNavigator software (Philips Healthcare).…”

mentioning

confidence: 99%

Fusion Image Guidance for Supra-Aortic Vessel Catheterization in Neurointerventions: A Feasibility Study

Feddal

Escalard

Delvoye

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Endovascular navigation through tortuous vessels can be complex. Tools that can optimise this access phase need to be developed. Our aim was to evaluate the feasibility of supra-aortic vessel catheterization guidance by means of live fluoroscopy fusion with MR angiography or CT angiography. MATERIALS AND METHODS:Twenty-five patients underwent preinterventional diagnostic MRA, and 8 patients underwent CTA. Fusion guidance was evaluated in 35 sessions of catheterization, targeting a total of 151 supra-aortic vessels. The time for MRA/CTA segmentation and fluoroscopy with MRA/CTA coregistration was recorded. The feasibility of fusion guidance was evaluated by recording the catheterizations executed by interventional neuroradiologists according to a standard technique under fluoroscopy and conventional road-mapping independent of the fusion guidance. Precision of the fusion roadmap was evaluated by measuring (on a semiquantitative 3-point scale) the maximum offset between the position of the guidewires/catheters and the vasculature on the virtual CTA/MRA images. The targeted vessels were divided in 2 groups according to their position from the level of the aortic arch. RESULTS:The average time needed for segmentation and image coregistration was 7 6 2 minutes. The MRA/CTA virtual roadmap overlaid on live fluoroscopy was considered accurate in 84.8% (128/151) of the assessed landmarks, with a higher accuracy for the group of vessels closer to the aortic arch (92.4%; OR, 4.88; 95% CI, 1.83-11.66; P ¼ .003). CONCLUSIONS:Fluoroscopy with MRA/CTA fusion guidance for supra-aortic vessel interventions is feasible. Further improvements of the technique to increase accuracy at the cervical level and further studies are needed for assessing the procedural time savings and decreasing the x-ray radiation exposure.W ith the increasing use of endovascular treatments for cerebrovascular diseases, in an aging population, physicians are more frequently facing complex endovascular navigation. Limitations to the navigation of endovascular devices from the aortic arch to the intracranial vessels still remain, 1,2 and the speed and safety of access through the vascular tortuosity need to be enhanced. 3 Access through tortuous vessels can make the treatment complex and leads to increased procedural time, x-ray exposure, and rate of adverse events or failure. 2,[4][5][6] Routine supra-aortic vessel catheterization in neurovascular procedures uses conventional road-mapping (superimposition of contrast-filled vessels on fluoroscopy using digital subtraction). It

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Improving workflows of neuro-interventional procedures with autostereoscopic 3D visualization of multi-modality imaging in hybrid interventional suites

Cited by 6 publications

References 7 publications

Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors

Feasibility and Safety of Cone-Beam Computed Tomography Advanced Navigation to Optimize Intra-arterial Chemotherapy Infusion of Skull Base Tumors

OsiriX software as a preoperative planning tool in cranial neurosurgery: A step-by-step guide for neurosurgical residents

Fusion Image Guidance for Supra-Aortic Vessel Catheterization in Neurointerventions: A Feasibility Study

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