Percutaneous Superimposed O-Arm-MRI-Navigated Biopsy for Spinal Column Pathologies

Abstract

Classifying spinal tumors can be challenging due to nonspecific clinical and radiological qualities, and a precise biopsy is crucial for an accurate diagnosis and treatment planning. This study aimed to enhance the accuracy and efficiency of spinal biopsies integrating Cone Beam Computed Tomography (CBCT) and magnetic resonance imaging (MRI) modalities using an O-arm CT navigation system. Eighteen patients with different spinal lesions underwent 18 biopsies following the Stealth Station navigation system Spine 8 protocol. Preoperative MRI scans were merged with intraoperative CT navigation systems for continuous monitoring during the biopsy process. The combined imaging technique accurately identified the diseased lesion type in all biopsies, demonstrating 100% sensitivity and specificity. In conclusion, combining MRI and CT imaging modalities significantly improved spinal biopsy accuracy and efficiency, differentiating between pathological entities. However, large-scale studies are desired to validate these findings and investigate potential benefits in different clinical scenarios. Although this method requires general anesthesia, its potential profits in avoiding misdiagnosed lesions and decreasing the need for further invasive procedures make it a promising approach for improving spinal biopsy accuracy and efficiency.

Evaluating Imaging Techniques for Diagnosing and Drainage Guidance of Psoas Muscle Abscess: A Systematic Review

“…Integrating an O-arm scan with MRI intraoperatively, combined with the navigation system, has already proven to be beneficial in managing various liver, kidney, and spinal column tumors, leveraging the distinct advantages of CT and MRI during surgical procedures [ 25 , 26 ]. Utilizing MRI’s detailed soft tissue visualization alongside the precise anatomical detail provided by CT ensures highly accurate targeting and the adequate drainage of abscesses.…”

“…The focus on imaging-guided PD reflects a critical step toward optimizing PMA management. However, we believe there is still space for improvement in guiding the PD process using fusion techniques (CT and MRI), especially since it has proven its efficacy in different percutaneous interventions, such as diagnosing and ablating different spinal column tumors or their management [ 25 , 26 ].…”

Enhanced Precision and Safety in Thermal Ablation: O-Arm Cone Beam Computed Tomography with Magnetic Resonance Imaging Fusion for Spinal Column Tumor Targeting

“…While CT scans are often recommended for hardto-reach lesions due to their high-resolution capabilities, which are particularly useful for visualizing the sides of vertebrae and thus minimizing the risk to neural elements [37], MRI excels in soft tissue and bone marrow contrast and certain lesions such as non-Hodgkin's lymphoma, can only be visualized using MRI [14,38,39]. A study by Al-Smadi et al involving 18 patients with spinal column tumors revealed that the tumors were either not visible, or their dimensions were underestimated when relying solely on CT scans, as opposed to MRI [19].…”