Department of Medical Physics, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin 53705, USA.
Neurosurgery. 2010 Sep;67(3 Suppl Operative):ons49-56; discussion ons56-7. doi: 10.1227/01.NEU.0000382976.18891.50.
Flat-panel cone-beam computed tomography (FP-CBCT) has recently been introduced as a clinical feature in neuroangiography radiographic C-arm systems.
To introduce a method of positioning a surgical tool such as a needle or ablation probe within a target specified by intraoperative FP-CBCT scanning.
Two human cadaver and 2 porcine cadaver heads were injected with a mixture of silicone and contrast agent to simulate a contrast-enhanced tumor. Preoperative imaging was performed using a standard 1.5-T magnetic resonance imaging scanner. Intraoperative imaging was used to define the needle trajectory on a GE Innova 4100 flat panel-based neuroangiography C-arm system.
Using a combination of FP-CBCT and fluoroscopy, a needle was successfully positioned within each of the simulated contrast-enhanced tumors, as verified by subsequent FP-CBCT scans.
This proof-of-concept study demonstrates the potential utility of combining FP-CBCT scanning with fluoroscopy to position surgical tools when stereotactic devices and image-guided surgery systems are not available. However, further work is required to fully characterize the precision and accuracy of the method in a variety of realistic surgical sites.
平板锥形束 CT（FP-CBCT）最近已作为神经血管造影射线 C 臂系统的临床特征引入。
介绍一种在术中 FP-CBCT 扫描指定的目标内定位手术工具（如针或消融探针）的方法。
对 2 个人体和 2 个猪尸体头颅进行了硅酮和对比剂混合物的注射，以模拟增强对比的肿瘤。术前成像使用标准的 1.5T 磁共振成像扫描仪进行。术中成像用于在 GE Innova 4100 基于平板的神经血管造影 C 臂系统上定义针的轨迹。
使用 FP-CBCT 和透视相结合的方法，成功地将针定位在每个模拟的增强对比肿瘤内，后续的 FP-CBCT 扫描验证了这一点。
这项概念验证研究表明，在没有立体定向设备和图像引导手术系统的情况下，将 FP-CBCT 扫描与透视相结合定位手术工具具有潜在的应用价值。然而，需要进一步的工作来充分描述该方法在各种实际手术部位的精度和准确性。
