Application accuracy in frameless image-guided neurosurgery: a comparison study of three patient-to-image registration methods
Application accuracy in frameless image-guided neurosurgery: a comparison study of three patient-to-image registration methods
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DOI：
10.3171/jns.2007.106.6.1012
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发表时间：
2007-06-01
影响因子：
4.1
通讯作者：
Van der Sprenkel, Jan Willem Berkelbach
中科院分区：
文献类型：
--
作者：
Woerdeman, Peter A.;Willems, Peter W. A.;Van der Sprenkel, Jan Willem Berkelbach
目的。本研究的目的是比较无框立体定位中三种患者到图像配准方法的应用准确性（术中确定目标位置的准确性）。在无框立体定位中，成像信息被转移到手术视野以显示定位器或手术器械的空间位置。采用刚体变换算法，基于点对匹配或面匹配的方法，计算图像体积与手术工作空间之间的数学关系。该研究纳入了 50 名计划接受无框架图像引导神经外科手术的患者。手术前，患者接受计算机断层扫描 (CT) 扫描或磁共振 (MR) 成像，并在头皮上广泛分布粘合基准标记。将额外的基准标记放置在头部作为目标，尽可能靠近颅内病变。在每次手术之前，使用光学跟踪系统使用解剖标志、粘合标记或表面匹配来执行三个独立的患者到图像配准程序。每次配准后，确定目标配准误差 (TRE)，定义为目标标记的图像空间坐标和世界空间坐标之间的欧几里德距离。与目标位置或成像模式无关，使用粘合标记时，平均应用精度（+/- 标准偏差）为 2.49 +/- 1.07 毫米。使用其他两种配准策略，平均 TRE 显着更大（表面匹配，5.03 +/- 2.30 毫米；解剖标志，4.97 +/- 2.29 毫米；两者的 p < 0.001）。结论。本研究结果表明，皮肤粘合基准标记配准是最准确的无创配准方法。当要使用早期研究的图像并且准确性可能会稍微受到影响时，解剖标志和表面匹配是同样准确的替代方案。
Object. The aim of this study was to compare three patient-to-image registration methods in frameless stereotaxy in terms of their application accuracy (the accuracy with which the position of a target can be determined intraoperatively). In frameless stereotaxy, imaging information is transposed to the surgical field to show the spatial position of a localizer or surgical instrument. The mathematical relationship between the image volume and the surgical working space is calculated using a rigid body transformation algorithm, based on point-pair matching or surface matching.Methods. Fifty patients who were scheduled to undergo a frameless image-guided neurosurgical procedure were included in the study. Prior to surgery, the patients underwent either Computerized tomography (CT) scanning or magnetic resonance (MR) imaging with widely distributed adhesive fiducial markers on the scalp. An extra fiducial marker was placed on the head as a target, as near as possible to the intracranial lesion. Prior to each surgical procedure, an optical tracking system was used to perform three separate patient-to-image registration procedures, using anatomical landmarks, adhesive markers, or surface matching. Subsequent to each registration, the target registration error (TRE), defined as the Euclidean distance between the image space coordinates and world space coordinates of the target marker, was determined.Independent of target location or imaging modality, mean application accuracy (+/- standard deviation) was 2.49 +/- 1.07 mm when using adhesive markers. Using the other two registration strategies, mean TREs were significantly larger (surface matching, 5.03 +/- 2.30 mm; anatomical landmarks, 4.97 +/- 2.29 mm; p < 0.001 for both).Conclusions. The results of this study show that skin adhesive fiducial marker registration is the most accurate noninvasive registration method. When images from an earlier study are to be used and accuracy may be slightly compromised, anatomical landmarks and surface matching are equally accurate alternatives.