Taeger Johannes, Müller-Graff Franz-Tassilo, Neun Tilmann, Köping Maria, Schendzielorz Philipp, Hagen Rudolf, Rak Kristen
Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Bavaria, Germany.
Institute for Diagnostical and Interventional Neuroradiology, University Hospital Würzburg, Würzburg, Bavaria, Germany.
Sci Prog. 2021 Jul-Sep;104(3):368504211032090. doi: 10.1177/00368504211032090.
This study aimed to evaluate the feasibility and accuracy of electromagnetic navigation at the lateral skull base in combination with flat panel volume computed tomography (fpVCT) datasets. A mastoidectomy and a posterior tympanotomy were performed on 10 samples of fresh frozen temporal bones. For registration, four self-drilling titanium screws were applied as fiducial markers. Multi-slice computed tomography (MSCT; 600 µm), conventional flat panel volume computed tomography (fpVCT; 466 µm), micro-fpVCT (197 µm) and secondary reconstructed fpVCT (100 µM) scans were performed and data were loaded into the navigation system. The resulting fiducial registration error (FRE) was analysed, and control of the navigation accuracy was performed. The registration process was very quick and reliable with the screws as fiducials. Compared to using the MSCT data, the micro-fpVCT data led to significantly lower FRE values, whereas conventional fpVCT and secondary reconstructed fpVCT data had no advantage in terms of accuracy. For all imaging modalities, there was no relevant visual deviation when targeting defined anatomical points with a navigation probe. fpVCT data are very well suited for electromagnetic navigation at the lateral skull base. The use of titanium screws as fiducial markers turned out to be ideal for comparing different imaging methods. A further evaluation of this approach by a clinical trial is required.
本研究旨在评估电磁导航结合平板容积计算机断层扫描（fpVCT）数据集在侧颅底应用的可行性和准确性。对10个新鲜冷冻颞骨样本进行了乳突切除术和后鼓室切开术。为进行配准，应用了4枚自钻式钛螺钉作为基准标记物。进行了多层计算机断层扫描（MSCT；600 µm）、传统平板容积计算机断层扫描（fpVCT；466 µm）、微fpVCT（197 µm）和二次重建fpVCT（100 µM）扫描，并将数据加载到导航系统中。分析所得的基准配准误差（FRE），并进行导航准确性控制。以螺钉作为基准时，配准过程非常快速且可靠。与使用MSCT数据相比，微fpVCT数据导致FRE值显著更低，而传统fpVCT和二次重建fpVCT数据在准确性方面没有优势。对于所有成像方式，使用导航探针靶向定义的解剖点时均无明显视觉偏差。fpVCT数据非常适合用于侧颅底的电磁导航。事实证明，使用钛螺钉作为基准标记物对于比较不同成像方法非常理想。需要通过临床试验对该方法进行进一步评估。
