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Application of individualized localization technology based on multimodal image spatial coordinate mapping in
Yongzhen Hu1, Haitong Xu1, Jianhao Liang1
1Department of Neurosurgery, The Affiliated Huizhou Hospital, Guangzhou Medical University, Huizhou, China.
Background:
The suboccipital retrosigmoid approach is classic for cerebellopontine angle lesions, but accurate localization of the transverse sinus (TS), sigmoid sinus (SS), and transverse-sigmoid sinus junction (TSSJ) remains challenging due to anatomical variations. Traditional landmark-based localization is prone to venous sinus injury, highlighting the need for precise preoperative planning.
Objectives:
To evaluate the efficacy of 3D Slicer-assisted individualized localization technology based on multimodal image spatial coordinate mapping for TS, SS, and TSSJ in suboccipital retrosigmoid surgery, and to assess its value in reducing complications and optimizing surgical outcomes.
Methods:
A retrospective sequential before-and-after cohort analysis included 91 patients (December 2023-October 2025) divided into the experimental group (n = 52, 3D Slicer-aided CT/CTV fusion + 3D reconstruction) and control group (n = 39, traditional 2D imaging + surface landmarks). Key indicators (keyhole positioning accuracy, venous sinus injury rate, craniotomy time, intraoperative blood loss, postoperative hospital stay) were compared using R 4.5 software.
Results:
Baseline data were balanced between groups (all P > 0.05). The experimental group achieved 100% keyhole positioning accuracy (vs. 76.9% in controls, P < 0.001) and zero venous sinus injury (vs. 10.3% in controls, P = 0.031). Craniotomy time (28.12 ± 3.82 vs. 35.64 ± 5.51 min), intraoperative blood loss (64.81 ± 10.84 vs. 97.74 ± 51.03 ml), and postoperative hospital stay (7.81 ± 1.5 vs. 10.51 ± 5.9 days) were significantly improved in the experimental group (all P < 0.001). Learning curve analysis showed experimental group preoperative planning time declined with experience: inflection point at Case 7, 16.0% time reduction (29.29 ± 4.96 to 24.60 ± 4.14 min, P = 0.048), and learning rate 0.095.
Conclusions:
3D Slicer-assisted individualized localization is associated with improved precision of TS-SS complex positioning, reduced venous sinus injury risk, and optimized surgical efficiency. Its low-cost and user-friendly features correlate with favorable conditions for adoption within primary-hospital settings, showing promising clinical application prospects.