von Jako Christopher R, Perlaki Gabor, Orsi Gergely, Schwarcz Attila, Dóczi Tamás
NeuroTherm, Inc., Wilmington, Mass., USA.
Stereotact Funct Neurosurg. 2014;92(1):1-7. doi: 10.1159/000354819. Epub 2013 Nov 8.
Neuronavigation devices have progressed over the past 2 decades, but logistical limitations remain for many stereotactic procedures. We describe our technique and accuracy for a novel miniature optical tracking system which overcomes these limitations.
The minioptical tracking system uses a miniature video camera mounted on a rigid cannula to determine cannula location and orientation relative to a patient-attached sticker containing reference markers. A CT scan is used to register these markers to the anatomy and a user-selected target. A computer displays the cannula guidance information to the target. Bench testing was performed on 225 targets in a custom test phantom and additional testing was performed on 20 small targets in an anthropomorphic head phantom to determine the practical accuracy and workflow.
The phantom study demonstrated that 3-D navigation accuracy is 1.41 ± 0.53 mm. There was a 100% head phantom study success rate for the 20 small targets.
The resulting accuracy data demonstrated good correlation with the CT data, and the clinical simulation workflow indicated its potential usefulness for common neurosurgical applications. Furthermore, this small-footprint tracking technology does not experience the traditional environmentally induced issues or the requirement of pin-based head fixation, allowing for use in the neurointensive care unit and the emergency department.
在过去20年中，神经导航设备取得了进展，但许多立体定向手术仍存在后勤方面的限制。我们描述了一种新型微型光学跟踪系统的技术及准确性，该系统克服了这些限制。
微型光学跟踪系统使用安装在刚性套管上的微型摄像机，以确定套管相对于粘贴在患者身上、带有参考标记的贴纸的位置和方向。利用CT扫描将这些标记与解剖结构及用户选择的目标进行配准。计算机将套管引导信息显示给目标。在定制测试模型上对225个目标进行了台架测试，并在拟人化头部模型上对20个小目标进行了额外测试，以确定实际准确性和工作流程。
模型研究表明，三维导航精度为1.41±0.53毫米。对20个小目标的头部模型研究成功率为100%。
所得的准确性数据与CT数据显示出良好的相关性，临床模拟工作流程表明其在常见神经外科应用中的潜在用途。此外，这种小尺寸跟踪技术不存在传统的环境诱导问题，也无需基于销钉的头部固定，可用于神经重症监护病房和急诊科。
