Optimized Intraoperative Imaging for Stereotactic Planning with a Multiaxial Robotic C-arm System: Technical Note and...

Area of Science:

• Neurosurgery
• Medical Imaging
• Robotics

Background:

• Preoperative planning for stereotactic brain biopsy is logistically demanding and burdensome for patients.
• Intraoperative imaging offers a potential solution to overcome these limitations.

Purpose of the Study:

• To develop and implement a novel method for intraoperative planning dataset acquisition using the Artis zeego multiaxial robotic C-arm system.
• To evaluate the feasibility and effectiveness of this new approach for frame-based stereotactic brain biopsy.

Main Methods:

• A customized, dose-reduced protocol for the Artis zeego system was developed and integrated into the clinical workflow.
• A cohort of 14 patients underwent intraoperative imaging with Artis zeego, compared against a control group of 10 patients with conventional preoperative CT.
• Outcomes assessed included target deviation, biopsy diagnostic value, complications, and procedure time.

Main Results:

• A suitable intraoperative planning dataset was successfully acquired in all Artis zeego patients.
• Total procedure time was significantly shorter in the Artis zeego group (p=0.01).
• Biopsy diagnostic yield was high in both groups (86% Artis zeego vs. 80% control), with no significant differences in accuracy metrics.

Conclusions:

• Intraoperative imaging with Artis zeego is a feasible and straightforward method for frame-based stereotactic brain biopsy.
• This technique achieves accuracy comparable to conventional CT while potentially reducing radiation exposure.
• The method significantly shortens overall procedure length and enhances patient and staff comfort.