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Laser-assisted flat-detector CT-guided intracranial access.

Daniel L Cooke1, Michael R Levitt2,3, Louis J Kim4,5

  • 1Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.

International Journal of Computer Assisted Radiology and Surgery
|August 5, 2015
PubMed
Summary

Laser-assisted flat-detector CT provides accurate targeting for intracranial lesions in neurosurgery models. This technique shows high precision for minimally invasive procedures.

Keywords:
BiopsyC-armCone beam computed tomographyDimensional measurement accuracyFlat-panel detectorImage-guided surgeryPhantom study

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Flat-detector computed tomography (CT) integration with C-arm fluoroscopy enables CT-guided neurosurgical and endovascular procedures.
  • Accurate targeting is crucial for minimally invasive intracranial interventions.

Purpose of the Study:

  • To evaluate the accuracy of laser-assisted flat-detector CT guidance for targeting intracranial lesions.
  • To assess the feasibility of this technique in a cranial model.

Main Methods:

  • A cranial model with embedded 2.16-mm targets was used.
  • Flat-detector CT was acquired and registered to the model.
  • Biopsy needles were guided using fluoroscopy, CT overlay, and laser assistance to access targets.

Main Results:

  • Ten targets were successfully accessed using XperGuide software.
  • Needle placement accuracy was within 1.30 ± 0.63 mm of the target isocenter.
  • Accuracy was consistent across different entry sites, operators, locations, and lesion depths.

Conclusions:

  • Laser-assisted flat-detector CT guidance achieved excellent accuracy for intracranial targeting in a model.
  • This technique holds promise for various minimally invasive neurosurgical procedures.