Accuracy of Laser Placement With Frameless Stereotaxy in Magnetic Resonance-Guided Laser-Induced Thermal Therapy
Accuracy of Laser Placement With Frameless Stereotaxy in Magnetic Resonance-Guided Laser-Induced Thermal Therapy
复制标题
DOI：
10.1227/neu.0000000000000967
复制
发表时间：
2015-12-01
影响因子：
2.3
通讯作者：
Danish, Shabbar F.
中科院分区：
文献类型：
--
作者：
Attaar, Sakina J.;Patel, Nitesh V.;Danish, Shabbar F.
背景：随着磁共振引导激光诱导热疗 (MRgLITT) 越来越被接受，需要对实现精确激光放置所需的技术进行评估。 目的：报告我们在无框架立体定位方面的经验以及实现精确激光放置的能力。我们还评估了与正确放置相关的变量。方法：我们对 3 年的 MRgLITT 进行了回顾性分析。记录并比较人口统计和操作参数，包括轨迹长度、目标对准误差、配准误差和径向误差。对消融的完整性采用盲法审查。结果：在该研究中，对 72 例病例的 90 次激光放置进行了评估。轨迹长度和目标对准误差分别为 95.3 +/- 26.0 毫米和 0.7 +/- 0.3 毫米。 4 个（0.6 +/- 0.3 毫米）和 5 个（0.5 +/- 0.2 毫米）颅骨钉之间的配准误差存在显着差异（P = .04），但随着附加颅骨钉的登记，配准误差没有显着下降。十五次激光放置导致了部分切除。使用无框架立体定位的总体径向误差为 0.9 +/- 1.6 毫米。在这项研究中，65% 的激光完全位于计划的轨迹上。在 30 个不存在的情况下，径向误差 = 2.6 +/- 1.9 毫米。小计激光烧蚀的径向误差为 0.5 ± 0.9（范围，0-2.8 毫米），与激光总切除的径向误差 0.8 +/- 1.7（范围，0-7.1 毫米）没有显着差异。消融 (P = .52)。径向误差 >0 mm 的激光导致 26.7% 的病例发生不完全消融。结论：MRgLITT 的基于颅骨钉的无框架立体定位术具有一致的准确性，大多数病例都导致完全消融。 RE >0 mm 的大部分激光仍会导致完全烧蚀。
BACKGROUND: As Magnetic resonance-guided laser-induced thermal therapy (MRgLITT) becomes more accepted, there needs to be an evaluation of the techniques required to achieve accurate laser placement.OBJECTIVE: To report our experience with frameless stereotaxy and the ability to achieve accurate laser placements. We also evaluate the variables associated with proper placement.METHODS: We performed a retrospective analysis from 3 years of MRgLITT. Demographics and operational parameters, including trajectory length, target alignment error, registration error, and radial error were recorded and compared. Blinded review was used for completeness of ablation.RESULTS: In the study, 90 laser placements were evaluated for 72 cases. Trajectory length and target alignment error was 95.3 +/- 26.0 mm and 0.7 +/- 0.3 mm, respectively. Significant differences existed in registration error between 4 (0.6 +/- 0.3 mm) and 5 (0.5 +/- 0.2 mm) skull pins (P = .04), but no significant decreases in registration error as additional skull pins were registered. Fifteen laser placements resulted in subtotal ablations. The overall radial error using frameless stereotaxy was 0.9 +/- 1.6 mm. In the study, 65% of lasers were exactly on the planned trajectory. Of the 30 that were not, the radial error = 2.6 +/- 1.9 mm. Radial error of subtotal laser ablations was 0.5 0.9 (range, 0-2.8 mm) and was not significantly different from 0.8 +/- 1.7 (range, 0-7.1 mm) radial error of lasers with total. ablations (P = .52). Lasers with radial error >0 mm resulted in an incomplete ablation in 26.7% of cases.CONCLUSION: Skull pin-based frameless stereotaxy for MRgLITT results in consistent accuracy, with the majority of cases resulting in complete ablations. A significant proportion of lasers with RE >0 mm still result in complete ablations.