Increase of accuracy in intraoperative navigation through high-resolution flat-panel volume computed tomography:...

Area of Science:

• Medical Imaging
• Surgical Navigation
• Neurosurgery

Background:

• Intraoperative navigation is crucial in head and neck surgery but limited in the lateral cranial base due to low accuracy.
• Surgical accuracy heavily depends on the resolution of imaging data.
• Flat-panel volume computed tomography (fpVCT) provides nearly double the resolution of multislice computed tomography (MSCT).

Purpose of the Study:

• To evaluate the impact of fpVCT on surgical navigation accuracy.
• To determine if fpVCT reduces target registration error (TRE) compared to MSCT.
• To assess the potential of fpVCT for novel navigated surgery concepts.

Main Methods:

• An acrylic glass phantom with 37 fiducial points was scanned using both MSCT and fpVCT.
• An optical navigation system was used to register data sets and measure TRE.
• TRE was calculated by measuring the distance between the pointer tip and fiducial points, with repeated measurements for statistical analysis.

Main Results:

• The average TRE using MSCT was 0.82 mm (SD, 0.35 mm).
• The average TRE using fpVCT was significantly lower at 0.46 mm (SD, 0.22 mm) (p < 0.01).
• fpVCT demonstrated a substantial reduction in navigation error compared to MSCT.

Conclusions:

• Submillimeter surgical navigation accuracy is achievable with high-resolution fpVCT.
• fpVCT-based navigation holds significant promise for enhancing cranial base surgery.
• This technology could enable new navigated surgical approaches in complex anatomical regions.