Comparison of frameless stereotactic systems: accuracy, precision, and applications

Area of Science:

• Neurosurgery
• Medical Technology
• Surgical Navigation

Background:

• Frameless stereotactic systems are essential in neurosurgery.
• Three systems with different localization technologies (mechanical, magnetic, optical) were evaluated.
• The Cygnus PFS system, a portable option, was compared against larger established systems.

Purpose of the Study:

• To compare the accuracy of the Cygnus PFS system with the SMN and ISG viewing wand systems.
• To evaluate the precision of these frameless stereotactic technologies.
• To inform the selection of stereotactic systems based on performance and practical factors.

Main Methods:

• Accuracy and precision of three frameless stereotactic systems were measured using a stereotactic phantom.
• Identical datasets and 10 magnetic resonance imaging datasets were used for analysis.
• Localization errors in three-dimensional space for nine targets were calculated.

Main Results:

• The ISG viewing wand system achieved the highest mean accuracy (1.67 +/- 0.43 mm).
• The Cygnus PFS system demonstrated a mean accuracy of 1.90 +/- 0.7 mm.
• The SMN microscope system had a mean accuracy of 2.61 +/- 0.99 mm.
• Precision did not significantly differ among the evaluated systems.

Conclusions:

• Small differences in accuracy and precision were observed among the three frameless stereotactic systems.
• Factors beyond accuracy, such as portability and ease of use, are crucial for system selection.
• The choice of a frameless stereotactic system should consider a balance of performance and practical clinical application.