| An Optimized System for Interventional MRI Guided Stereotactic Surgery: Preliminary Evaluation of Targeting Accuracy. | |
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MedLine Citation:
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PMID: 21796000 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Deep brain stimulation (DBS) electrode placement using interventional MRI has been previously reported using a commercially available skull mounted aiming device (Medtronic Nexframe MR) and native MRI scanner software. This first-generation method has technical limitations that are inherent to the hardware and software used. A novel system (SurgiVision ClearPoint) consisting of an aiming device (SMARTFrame) and software has been developed specifically for iMRI interventions including DBS. OBJECTIVE:: A series of phantom and cadaver tests were performed to determine the system's capability, preliminary accuracy and workflow. METHODS:: 18 experiments using a water phantom were used to determine predictive accuracy of the software. 16 experiments using a gelatin-filled skull phantom were used to determine targeting accuracy of the aiming device. 6 procedures in three cadaver heads were performed to compare workflow and accuracy of ClearPoint with Nexframe MR. RESULTS:: Software prediction experiments showed an average error of 0.9±0.5 mm in magnitude in pitch and roll (mean pitch error -0.2±0.7 mm, mean roll error +0.2±0.7 mm) and an average error of 0.7±0.3 mm in X-Y translation with a slight anterior (0.5±0.3 mm) and lateral (0.4±0.3mm) bias. Targeting accuracy experiments showed average radial error of 0.5±0.3 mm. Cadaver experiments showed a radial error of 0.2±0.1 mm with the ClearPoint system (average procedure time 88±14 minutes) vs 0.6±0.2 mm with the Nexframe MR (average procedure time 92±12 minutes). CONCLUSION:: This novel system provides the submillimetric accuracy required for stereotactic interventions including DBS placement. It also overcomes technical limitations inherent in the first-generation iMRI system. |
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Authors:
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Paul S Larson; Philip A Starr; Geoffrey Bates; Lisa Tansey; R Mark Richardson; Alastair J Martin |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-25 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; 2SurgiVision, Inc, Irvine, CA, USA; 3Department of Radiology, University of California, San Francisco, San Francisco, CA, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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