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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Accuracy in robot assisted surgery comparing leksell frame vs laser scan referencing based on mr or ct data

Meeting Abstract

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  • Andrea Spyrantis - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Adriano Cattani - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Tirza Woebbecke - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Adam Strzelczyk - Universitätsklinikum Frankfurt, Klinik für Neurologie, Frankfurt am Main, Deutschland
  • Manfred Kudernatsch - Schön Klinik Vogtareuth, Abteilung für Neurochirurgie, Vogtareuth, Deutschland
  • Volker Seifert - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Thomas Freiman - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV180

doi: 10.3205/18dgnc183, urn:nbn:de:0183-18dgnc1837

Published: June 18, 2018

© 2018 Spyrantis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: In robotic guided stereotaxic procedures, as implantation of intracerebral electroencephalography electrodes (sEEG), referencing the patients anatomy to the robot is the most crucial step. We will compare the accuracy of different referencing methods. First, computed tomography (CT) with stereotaxic frame, second, CT and laser scanning of the face and, third, magnetic resonance tomography (MR) and laser scanning.

Methods: In total, 171 sEEG electrodes were implanted in 19 patients assisted by the robotic surgery assistant (ROSA). Referencing was accomplished either by CT-based Leksell frame (n=49), CT-based laser scan of the face (n=60) and MR-based laser scan (n=62). Preoperative MR-based planning data was compared with the postoperative position of the sEEG-electrode by CT. The accuracy was determined by the target point error (TPE) and the entry point error (EPE) applying the Euclidian distance.

Results: In Leksell frame-based referencing, the TPE amounted to 2,28 mm, the EPE to 0,86 mm (n=49). CT based laser scan referencing resulted in a TPE of 2,41 mm and an EPE of 1,85 mm. Using the 3.0 T MR based laser scan for referencing, the mean TPE amounted to 3.51 mm, the mean EPE to 3,02mm (n=56). The accuracy improved combining 1.5 T MRI with laser scan, the mean TPE dropped to 1.71 mm, the EPE 0.97 mm (n=6). Two clinically inapparent hemorrhages were detected in patients with CT based laser scan for referencing. No further complications were observed.

Conclusion: Robot-guided sEEG with Leksell frame based referencing is very accurate and can serve for high precision placement of electrodes. In contrast, 3.0 T MRI based laser scan referencing saves radiation for the patient and most trajectories can be reached by using alternative routes over less vessel dens brain areas.