Intraoperative cone-beam CT for head and neck surgery: Feasibility of clinical implementation using a prototype mobile C-arm
Intraoperative cone-beam CT for head and neck surgery: Feasibility of clinical implementation using a prototype mobile C-arm
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DOI：
10.1002/hed.23060
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发表时间：
2013-07-01
影响因子：
2.9
通讯作者：
Irish, Jonathan C.
中科院分区：
文献类型：
--
作者：
King, Emma;Daly, Michael J.;Irish, Jonathan C.
背景头颈外科手术中的三维成像是使用锥束CT(CBCT)的原型移动式C臂开发的。本文总结了它在一个预期的试点和可行性研究中的实施情况。方法对12例头颈部肿瘤患者应用CBCT C臂扫描。采用人因工程学方法和来自外科医生、护士和麻醉师的专家反馈，评估术中成像对手术环境和临床工作流程的影响。评价CBCT的图像质量和临床实用价值。结果CBCT C形臂在12例头颈部病例中成功植入，并顺利进入手术环境。回顾的3D-CBCT图像在质量上足以在术中引导骨骼细节。需要额外的伪影管理来改善软组织可视化。结论术中CBCT为骨骼细节的可视化提供了高质量的图像，在具有可接受的工作流程中断的情况下，在大型头颈手术中是可行的。涉及复杂3D解剖结构的重大骨消融和/或重建的手术很可能受益于更新的成像。(C)2012年威利期刊公司Head Neck，2013
Background Intraoperative 3-dimensional (3D) imaging in head and neck surgery was developed using a prototype mobile C-arm for cone-beam CT (CBCT). This article summarizes its implementation in a prospective pilot and feasibility study. Methods The CBCT C-arm was used in 12 head and neck surgical oncology cases. Human-factors engineering methods and expert feedback from surgeons, nurses, and anesthetists were used to evaluate the impact of intraoperative imaging on the surgical environment and clinical workflow. Image quality of CBCT and the perceived clinical utility were evaluated. Results The CBCT C-arm was successfully incorporated in 12 head and neck cases and streamlined into the surgical environment. Reviewed 3D-CBCT images were qualitatively sufficient for intraoperative-guidance for bony detail. Additional artifact management is required to improve soft-tissue visualization. Conclusions Intraoperative CBCT provides high-quality images for visualization of bony detail and is feasible during major head and neck surgery with acceptable workflow interruptions. Operations with significant bone ablation and/or reconstruction involving complex 3D anatomical structures are likely to benefit from the updated imaging. (c) 2012 Wiley Periodicals, Inc. Head Neck, 2013