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. 2016 Mar;11(3):467-72.
doi: 10.1007/s11548-015-1271-5. Epub 2015 Aug 5.

Laser-assisted flat-detector CT-guided intracranial access

Daniel L Cooke  1 , Michael R Levitt  2   3 , Louis J Kim  4   5 , Danial K Hallam  4   5 , Laligam N Sekhar  4 , Basavaraj V Ghodke  4   5
Affiliations

Laser-assisted flat-detector CT-guided intracranial access

Daniel L Cooke et al. Int J Comput Assist Radiol Surg. 2016 Mar.

Abstract

Purpose: Flat-detector CT can be integrated with C-arm fluoroscopy for CT-guided neurosurgical and endovascular procedures. We studied the accuracy of this technique with laser assistance in targeting intracranial lesions in a cranial model.

Methods: An acrylic scale-model skull containing foam parenchyma was embedded with 2.16-mm-diameter targets. A flat-detector CT was acquired and registered to the skull's position. Ten targets were accessed with biopsy needles under fluoroscopic guidance, flat-detector CT overlay, and laser assistance. Accuracy was measured from the needle tip to the target center using flat-detector CT.

Results: Ten targets were accessed successfully using XperGuide software. Needles were placed within 1.30 [Formula: see text] 0.63 mm of target isocenter. Accuracy did not vary by entry site, operator, location, or lesion depth.

Conclusions: Laser-assisted flat-detector CT-guided targeting of all intracranial targets was successful with excellent accuracy. This technique can be applied to other minimally invasive neurosurgical procedures.

Keywords: Biopsy; C-arm; Cone beam computed tomography; Dimensional measurement accuracy; Flat-panel detector; Image-guided surgery; Phantom study.

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