术中锥形束CT导航在良性骨肿瘤手术中的可行性研究
Feasibility study of intraoperative cone-beam CT navigation for benign bone tumour surgery.
作者信息
van Steenbergen Thomas R F, van der Geest Ingrid C M, Janssen Dennis, Rovers Maroeska M, Fütterer Jurgen J
机构信息
Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands.
Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Orthopaedics, Nijmegen, The Netherlands.
出版信息
Int J Med Robot. 2019 Jun;15(3):e1993. doi: 10.1002/rcs.1993. Epub 2019 Mar 20.
BACKGROUND
Intraoperative cone-beam computed tomography (CBCT) offers the advantage of navigation on the current anatomical situation and the possibility to take a control scan. We assessed the feasibility of using intraoperative CBCT for navigated intralesional curettage.
METHODS
Nine benign bone tumour patients were studied. Feasibility was assessed by describing the workflow and indications for navigation, scoring CBCT image quality and registration accuracy, and measuring scan and navigation set-up times. Short-term follow-up was described.
RESULTS
CBCT navigation was successful in all patients. Median tumour visibility, tumour delineation, and vital structure visibility scores were good. Median registration accuracy score was very good. Median scan and verification times were 5 and 3 minutes, respectively. One patient had a tumour recurrence after 6 months.
CONCLUSIONS
Intraoperative CBCT navigation is feasible and safe. Indications for use of navigation in clinical practice are closeness to vital structures, complexly shaped tumours or bone, minimally invasive surgery, and repeated surgery.
背景
术中锥形束计算机断层扫描（CBCT）具有根据当前解剖情况进行导航以及进行对照扫描的优势。我们评估了使用术中CBCT进行导航下病损内刮除术的可行性。
方法
对9例良性骨肿瘤患者进行了研究。通过描述导航的工作流程和适应证、对CBCT图像质量和配准精度进行评分以及测量扫描和导航设置时间来评估可行性。描述了短期随访情况。
结果
所有患者的CBCT导航均成功。肿瘤可见度、肿瘤轮廓勾画及重要结构可见度的中位数评分良好。配准精度的中位数评分非常好。扫描和验证时间的中位数分别为5分钟和3分钟。1例患者在6个月后出现肿瘤复发。
结论
术中CBCT导航是可行且安全的。在临床实践中使用导航的适应证包括靠近重要结构、肿瘤或骨骼形状复杂、微创手术以及再次手术。
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