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如何客观评估影像引导手术技术的影响。

How to objectively evaluate the impact of image-guided surgery technologies.

机构信息

Intuitive, 1020 Kifer Road, Sunnyvale, CA, 94086, USA.

出版信息

Eur J Nucl Med Mol Imaging. 2024 Aug;51(10):2869-2877. doi: 10.1007/s00259-023-06504-w. Epub 2023 Nov 16.

Abstract

PURPOSE

This manuscript aims to provide a better understanding of methods and techniques with which one can better quantify the impact of image-guided surgical technologies.

METHODS

A literature review was conducted with regard to economic and technical methods of medical device evaluation in various countries. Attention was focused on applications related to image-guided interventions that have enabled procedures to be performed in a minimally invasive manner, produced superior clinical outcomes, or have become standard of care.

RESULTS

The review provides examples of successful implementations and adoption of image-guided surgical techniques, mostly in the field of neurosurgery. Failures as well as newly developed technologies still undergoing cost-efficacy analysis are discussed.

CONCLUSION

The field of image-guided surgery has evolved from solely using preoperative images to utilizing highly specific tools and software to provide more information to the interventionalist in real time. While deformations in soft tissue often preclude the use of such instruments outside of neurosurgery, recent developments in optical and radioactive guidance have enabled surgeons to better account for organ motion and provide feedback to the surgeon as tissue is cut. These technologies are currently undergoing value assessments in many countries and hold promise to improve outcomes for patients, surgeons, care teams, payors, and society in general.

摘要

目的

本文旨在更好地理解各种方法和技术,以更好地量化影像引导手术技术的影响。

方法

对不同国家医疗器械评估的经济和技术方法进行了文献回顾。重点关注与影像引导介入相关的应用,这些应用使得手术能够以微创的方式进行,产生更好的临床结果,或已成为标准治疗。

结果

本综述提供了影像引导手术技术成功实施和采用的实例,主要集中在神经外科领域。讨论了失败的案例以及新开发的仍在进行成本效益分析的技术。

结论

影像引导手术领域已从单纯使用术前图像发展到利用高度特异性的工具和软件,实时为介入医生提供更多信息。虽然软组织的变形通常排除了在神经外科以外使用这些仪器,但光学和放射性引导的最新发展使外科医生能够更好地考虑器官运动,并为外科医生提供组织切割时的反馈。这些技术目前正在许多国家进行价值评估,有望改善患者、外科医生、护理团队、支付方和整个社会的治疗效果。

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