Intraoperative computed tomography as reliable navigation registration device in 200 cranial procedures

Area of Science:

• Neurosurgery
• Medical Imaging
• Radiation Oncology

Background:

• Standard patient registration methods in neurosurgery are user-dependent and prone to errors.
• Intraoperative imaging offers a more objective approach to patient registration.
• Accurate registration is critical for effective navigation during surgical procedures.

Purpose of the Study:

• To evaluate the accuracy and radiation dose of intraoperative computed tomography (CT) for navigation registration in cranial neurosurgery.
• To assess the feasibility of using low-dose CT protocols for this application.

Main Methods:

• A total of 200 patients undergoing various cranial neurosurgical procedures were included.
• Intraoperative CT was performed using a 32-slice movable CT scanner for automatic navigation registration.
• Registration accuracy was validated using skin fiducials independent of the registration process.

Main Results:

• Automatic registration demonstrated high accuracy, with a mean registration error of 0.93 ± 0.41 mm.
• Low-dose CT protocols maintained registration accuracy (0.72 ± 0.43 mm) compared to full-dose protocols (0.87 ± 0.36 mm).
• A significant reduction in effective radiation dose (up to 8-fold) was achieved with low-dose protocols.

Conclusions:

• Intraoperative CT is a reliable method for navigation registration in cranial neurosurgery.
• This technique offers high accuracy with substantially reduced radiation exposure.
• Low-dose intraoperative CT protocols are effective for navigation registration, improving patient safety.