C-arm cone beam CT guidance of sinus and skull base surgery: quantitative surgical performance evaluation and development of a novel high-fidelity phantom

2009 ◽  
Author(s):  
A. D. Vescan ◽  
H. Chan ◽  
M. J. Daly ◽  
I. Witterick ◽  
J. C. Irish ◽  
...  
Keyword(s):  
Performance Evaluation ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Ct Guidance ◽  
High Fidelity ◽  
Surgical Performance

High-accuracy 3D image-based registration of endoscopic video to C-arm cone-beam CT for image-guided skull base surgery

2011 ◽  
Author(s):  
Daniel J. Mirota ◽  
Ali Uneri ◽  
Sebastian Schafer ◽  
Sajendra Nithiananthan ◽  
Douglas D. Reh ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Cone Beam Ct ◽  
High Accuracy ◽  
Cone Beam ◽  
3D Image ◽  
Image Guided ◽  
Endoscopic Video

scholarly journals Intraoperative C-arm cone-beam computed tomography: Quantitative analysis of surgical performance in skull base surgery

2012 ◽  
Vol 122 (9) ◽  
pp. 1925-1932 ◽  
Author(s):  
Stella Lee ◽  
Gary L. Gallia ◽  
Douglas D. Reh ◽  
Sebastian Schafer ◽  
Ali Uneri ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Quantitative Analysis ◽  
Skull Base ◽  
Cone Beam Computed Tomography ◽  
Skull Base Surgery ◽  
Cone Beam ◽  
Surgical Performance

Evaluating an Image-Guided Operating Room with Cone Beam CT for Skull Base Surgery

2020 ◽  
Author(s):  
Nidal Muhanna ◽  
Catriona M. Douglas ◽  
Michael J. Daly ◽  
Harley H.L. Chan ◽  
Robert Weersink ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Image Quality ◽  
Skull Base ◽  
Image Guidance ◽  
Surgical Navigation ◽  
Skull Base Surgery ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Anatomical Landmarks ◽  
Registration Error

Abstract Importance Skull base surgery requires precise preoperative assessment and intraoperative management of the patient. Surgical navigation is routinely used for complex skull base cases; however, the image guidance is commonly based on preoperative scans alone. Objective The primary objective of this study was to assess the image quality of intraoperative cone-beam computed tomography (CBCT) within anatomical landmarks used in sinus and skull base surgery. The secondary objective was to assess the registration error of a surgical navigation system based on intraoperative CBCT. Design Present study is a retrospective case series of image quality after intraoperative cone beam CT. Setting The study was conducted at Toronto General Hospital and Princess Margaret Cancer Centre, University Health Network, Toronto. Participants A total of 46 intraoperative scans (34 patients, 21 skull base, 13 head and neck) were studied. Main outcome and measures Thirty anatomical landmarks (vascular, soft tissue, and bony) within the sinuses and anterior skull base were evaluated for general image quality characteristics: (1) bony detail visualization; (2) soft-tissue visualization; (3) vascular visualization; and (4) freedom from artifacts (e.g., metal). Levels of intravenous (IV) contrast enhancement were quantified in Hounsfield's units (HU). Standard paired-point registration between imaging and tracker coordinates was performed using 6 to 8 skin fiducial markers and the corresponding fiducial registration error (FRE) was measured. Results Median score for bony detail on CBCT was 5, remaining at 5 after administration of IV contrast. Median soft-tissue score was 2 for both pre- and postcontrast. Median vascular score was 1 precontrast and 3 postcontrast. Median score for artifacts on CBCT were 2 for both pre-and postcontrast, and metal objects were noted to be the most significant source of artifact. Intraoperative CBCT allowed preresection images and immediate postresection images to be available to the skull base surgeon. There was a significant improvement in mean (standard deviation [SD]) CT intensity in the left carotid artery postcontrast 334 HU (67 HU) (p < 10−10). The mean FRE was 1.8 mm (0.45 mm). Conclusions Intraoperative CBCT in complex skull base procedures provides high-resolution bony detail allowing immediate assessment of complex resections. The use of IV contrast with CBCT improves the visualization of vasculature. Image-guidance based on CBCT yields registration errors consistent with standard techniques.

scholarly journals Percutaneous Osteoplasty under Fluoroscopy and Cone-Beam CT guidance for Painful Sternal Metastases

2021 ◽  
Author(s):  
Xun-wei Liu ◽  
Zhi-guo Wang ◽  
Jin Peng ◽  
Gang Sun
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cone Beam Ct ◽  
Tumor Location ◽  
Cone Beam ◽  
Ct Guidance ◽  
Numerical Rating ◽  
Cement Distribution ◽  
Painful Bone Metastases

Abstract Background: Although percutaneous osteoplasty (POP) has been widely accepted and is now being performed for the treatment of painful bone metastases outside the spine, there are only scarced reports regarding osteoplasty in painful sternal metastases.Case presentation: The paper reported four patients with painful sternal metastasis who underwent POP under fluoroscopic and cone-beam CT guidance. The patients were three men and one woman (mean age, 66.25 years). Primary tumor location in lung is 3 cases, in thyroid is 1 case. In these cases, Pain was measured using a numerical rating scale (NRS), with scores ranging from 0 (no pain) to 10 (worst pain imaginable). The scores on the NRS in the four patients before POP were 9, 8, 8, and 9. After POP, the NRS scores decreased to 2, 3, 2, and 2, respectively, in follow-up at 6 months. Conclusions: POP is a safe and effective treatment for pain caused by metastatic bone tumors in the sternum. However, care and at tention should be paid to the insertion of a needle and cement distribution for better treatment effect

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