| Clinical Significance of a Frameless Stereotactic System for Accurate Brain Tumor Localization??Fiducial and Surface Registration |
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Joo-Yong Lee, Joon Cho, Young-Cho Koh, Sang-Keun Jang, Chang-Taek Moon, Hyun-Seung Kang, Woo-Jin Choe |
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Department of Neurosurgery, Konkuk University Hospital, College of Medicine, Konkuk University, Seoul, Korea |
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| Abstract |
Objective
A Neuronavigation system had been developed for use of preoperative computed tomography, magnetic resoance
imaging, and positron emission tomography as an adjunct for neurosurgical planning and intraoperative navigation. This clinical
study was designed to evaluate the safety, efficacy, and accuracy of the neuronavigation system in the brain tumor surgeries.
Methods
We used the system in 176 operations undergoing a wide range of brain tumor removal from August 2005 to July
2007, to assess its clinical usefulness and safety. The accuracy of the fiducial marker registration and the accuracy of the surface registration method were recorded and compared. The distributions of the accuracy measurement data were analysed. P
value <0.05 was consider statistically significant.
Results
In this series, there were no cases of critically complicated outcomes caused by the use of the system. A comparison
of two different patient-image registration techniques established that the fiducial marking method was a little more accurate
than the surface recording method (geometric means=1.35±0.21 versus 1.52±0.32mm) and there was statistically difference
in two methods. The registration accuracy achieved with MRI was nearly equivalent to that with CT in this study.
Conclusions
The clinical significance of the neuronavigation in this series were relatively accurate use of intraoperative guidance and safe surgical entry for the deep and small brain tumors. The neuronavigation was also useful in planning the location
and size of the scalp incision, craniotomy, or corticotomy, as well as surgical resection of the brain tumor. |
| Key Words:
Brain tumor, Image registration, Image guided surgery, Neuronavigation. |
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