Cooke Daniel L, Levitt Michael R, Kim Louis J, Hallam Danial K, Sekhar Laligam N, Ghodke Basavaraj V
Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.
Department of Neurological Surgery, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359924, Seattle, WA, 98104-2499, USA.
Int J Comput Assist Radiol Surg. 2016 Mar;11(3):467-72. doi: 10.1007/s11548-015-1271-5. Epub 2015 Aug 5.
Flat-detector CT can be integrated with C-arm fluoroscopy for CT-guided neurosurgical and endovascular procedures. We studied the accuracy of this technique with laser assistance in targeting intracranial lesions in a cranial model.
An acrylic scale-model skull containing foam parenchyma was embedded with 2.16-mm-diameter targets. A flat-detector CT was acquired and registered to the skull's position. Ten targets were accessed with biopsy needles under fluoroscopic guidance, flat-detector CT overlay, and laser assistance. Accuracy was measured from the needle tip to the target center using flat-detector CT.
Ten targets were accessed successfully using XperGuide software. Needles were placed within 1.30 [Formula: see text] 0.63 mm of target isocenter. Accuracy did not vary by entry site, operator, location, or lesion depth.
Laser-assisted flat-detector CT-guided targeting of all intracranial targets was successful with excellent accuracy. This technique can be applied to other minimally invasive neurosurgical procedures.
平板探测器CT可与C形臂荧光透视术相结合，用于CT引导下的神经外科手术和血管内手术。我们在颅骨模型中研究了这种在激光辅助下针对颅内病变进行靶向定位的技术的准确性。
一个含有泡沫实质的丙烯酸比例模型颅骨嵌入了直径2.16毫米的靶点。获取平板探测器CT图像并将其与颅骨位置配准。在荧光透视引导、平板探测器CT叠加和激光辅助下，用活检针穿刺10个靶点。使用平板探测器CT从针尖到靶点中心测量准确性。
使用XperGuide软件成功穿刺了10个靶点。针放置在距靶点等中心1.30 [公式：见正文] 0.63毫米范围内。准确性不因进针部位、操作者、位置或病变深度而有所不同。
激光辅助平板探测器CT引导下对所有颅内靶点的靶向定位均成功，准确性极佳。该技术可应用于其他微创神经外科手术。
