Article
Neuronavigation without preoperative Navigation CT / MRI: cost and time effective 3D Ultrasound Neuronavigation for surgical therapy of brain lesions
Neuronavigation ohne präoperative Navigations CT / MRT: Kosten- und zeitsparende 3D-Ultraschallnavigation zur neurochirurgischen Behandlung von Hirnläsionen
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Published: | May 4, 2005 |
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Outline
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Objective
To evaluate the suitability of cost and time effective Neuronavigation based only on intraoperatively acquired 3D Ultrasound dataset with neither preoperative Navigation data acqusition nor patient registration procedure.
Methods
13 patients with intracerebral lesions were selected for open surgery using the SonoWand 3D US-navigation system according to the dignity, extend and localisation of the lesion. The SonoWand system uses a 4-8 MHz phased array probe tracked by a passive infrared camera system for acquisition of 3-D-Ultrasound datasets. Thus beside conventional navigation based on preoperative CT or MRI datasets it is possible to navigate in intraoperative “realtime” datasets and therefore overcoming the brainshift problem. Additionally navigation in an intraoperative acquired 3D dataset is available without the need for registration of preoperative images. Hereby time, costs and organisation for acquisition of preoperative image datasets can be avoided. This is a major difference to other navigation systems. Navigation in the cases reported here was perfomed using intraoperative 3-D datasets only.
Results
In all 13 Patients sufficient 3-D Ultrasound datasets could be obtained. High quality of the US image data enabled adequate image interpretation thus resulting in a steep learning curve. In all cases target and regions of risk were detectable and the information achieved was judged helpful by the surgeon. The system required a preparation time of below 4 min (including mounting of the patient tracker to the mayfield clamp, draping of the US probe and definition of the patient position), which is a tolerable delay even in emergencies.
Conclusions
3D Ultrasound Neuronavigation using the SonoWand System based on intraoperatively acquired 3D Ultrasound dataset only has proved to be suitable for surgical therapy of brain lesions in selected patients. In our preliminary experiences this is suitable in about half of all cases in which 3D neuronavigation is required. This technique avoids the need for acquisition of preoperative datasets and patient’s registration. Thus navigation can be performed with less expense of time, costs and organisation.