A simple technique for interventional tool placement combining fluoroscopy with interventional computed tomography on...

Area of Science:

• Medical Imaging
• Surgical Navigation
• Interventional Radiology

Background:

• Flat-panel cone-beam computed tomography (FP-CBCT) is a new feature in neuroangiography C-arm systems.
• Accurate surgical tool positioning is crucial for effective interventions.

Purpose of the Study:

• To develop and evaluate a method for precise surgical tool placement using intraoperative FP-CBCT.
• To guide instruments like needles or ablation probes to targets identified via FP-CBCT.

Main Methods:

• Simulated contrast-enhanced tumors were created in human and porcine cadaver heads.
• Preoperative MRI and intraoperative FP-CBCT imaging were utilized.
• Needle trajectory was defined using a GE Innova 4100 C-arm system.

Main Results:

• A needle was successfully positioned within simulated tumors in all tested cadaver heads.
• The accuracy of needle placement was confirmed by subsequent FP-CBCT scans.
• The combination of FP-CBCT and fluoroscopy proved effective for guidance.

Conclusions:

• This proof-of-concept study shows FP-CBCT and fluoroscopy can guide surgical tools without stereotactic systems.
• The method offers potential utility in various surgical scenarios.
• Further research is needed to determine precision and accuracy in diverse clinical settings.