Widmann Gerlig, Zangerl Antoniette, Schullian Peter, Fasser Martin, Puelacher Wolfgang, Bale Reto
SIP-Department for Microinvasive Therapy, Medical University of Innsbruck, Innsbruck, Austria.
J Oral Maxillofac Surg. 2012 Sep;70(9):2165-73. doi: 10.1016/j.joms.2011.08.026. Epub 2011 Nov 12.
Cone-beam computed tomography (CBCT) is increasingly used in craniofacial imaging and may be an interesting option for navigated surgery. The purpose of this study was to evaluate the accuracy of various registration techniques in CBCT compared with intraoperative and diagnostic multislice spiral computed tomography (MSCT).
High-resolution images of an anthropomorphic skull phantom with target markers were obtained using 2 CBCT machines (KaVo 3D eXam, ILUMA), an intraoperative MSCT (Sensation Open), and the standard diagnostic MSCT (LightSpeed VCT). Bone markers, a registration template, and an external registration frame were used for registration with an optical-based navigation system. Target registration errors (TREs) were evaluated and statistically analyzed in SPSS (P < .05).
The mean ± standard deviation for overall TREs of the KaVo 3D eXam, ILUMA, Sensation Open, and LightSpeed VCT devices were 1.37 ± 0.54, 1.67 ± 0.65, 1.27 ± 0.52, and 1.31 ± 0.30 mm, respectively. The KaVo 3D eXam showed no significant differences compared with the MSCTs. The ILUMA imaged the external registration frame only marginally and showed significant higher TREs compared with the other registration methods (P < .001). In the 2 MSCTs, no significant differences between the registration methods were found.
CBCT and intraoperative MSCT may show comparable TREs as standard diagnostic MSCT. Bone markers are the gold standard. Registration templates and external registration frames are valuable alternatives. When using only external registration frames, CBCTs with a large scan field are recommended.
锥形束计算机断层扫描（CBCT）在颅面成像中的应用日益广泛，可能是导航手术的一个有吸引力的选择。本研究的目的是评估与术中及诊断性多层螺旋计算机断层扫描（MSCT）相比，CBCT中各种配准技术的准确性。
使用2台CBCT机器（卡瓦3D eXam、ILUMA）、一台术中MSCT（Sensation Open）和标准诊断性MSCT（LightSpeed VCT）获取带有靶标标记的仿真人头骨模型的高分辨率图像。使用骨标记、配准模板和外部配准框架与基于光学的导航系统进行配准。在SPSS中评估靶标配准误差（TREs）并进行统计分析（P <.05）。
卡瓦3D eXam、ILUMA、Sensation Open和LightSpeed VCT设备的总体TREs的平均值±标准差分别为1.37±0.54、1.67±0.65、1.27±0.52和1.31±0.30 mm。卡瓦3D eXam与MSCT相比无显著差异。ILUMA对外部配准框架成像仅略有显示，与其他配准方法相比显示出显著更高的TREs（P <.001）。在2台MSCT中，未发现配准方法之间存在显著差异。
CBCT和术中MSCT可能显示出与标准诊断性MSCT相当的TREs。骨标记是金标准。配准模板和外部配准框架是有价值的替代方法。仅使用外部配准框架时，建议使用扫描视野大的CBCT。
