Image-guided surgery: what is the accuracy?
Image-guided surgery: what is the accuracy?
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DOI：
10.1097/00020840-200502000-00008
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发表时间：
2005-02-01
影响因子：
1.6
通讯作者：
Fitzpatrick, J Michael
中科院分区：
文献类型：
--
作者：
Labadie, Robert F;Davis, Bryan M;Fitzpatrick, J Michael
综述目的：近年来，影像引导手术（IGS）系统在耳鼻喉科（尤其是鼻喉科）的应用呈指数级增长。使用它们的核心是了解每个系统的准确性。本综述的目的是讨论所有IGS系统中固有的误差。一个标准化的技术（目前使用的工程文献）的理解和报告错误IGS系统进行审查。使用这种技术，市售IGS系统的错误review.Recent发现：最常用的IGS系统依赖于皮肤的构象，而不是依赖于骨植入设备。对于这些系统，常规报告的平均精度为2 mm或更小。这一发现与基准标记无关（例如，专有耳机、皮肤贴附标记或皮肤表面的激光扫描）。CT扫描与术中解剖结构的基准定位和配准技术为每家公司专有。因此，报告系统规格存在很大差异，特别是IGS系统的错误。这种标准化的缺乏使得一个系统与另一个系统的比较变得困难，如果不是不可能的话。总结：通常用于神经病学的图像引导手术系统报告的平均精度为2 mm或更小。外科医生必须意识到这个值代表了误差分布的平均值。因此，可以预期95%的时间误差小于其平均值的约1.7倍。然而，每个IGS干预可能存在离群值（误差比平均值大得多和小得多）。如前所述，IGS系统的功能是补充而不是取代外科解剖学知识。
PURPOSE OF REVIEW: Use of image-guided surgery (IGS) systems in otolaryngology, particularly rhinology, has grown exponentially in recent years. Central to their use is the understanding of the accuracy of each system. The purpose of this review is to discuss the error inherent in all IGS systems. A standardized technique (currently used in the engineering literature) for understanding and reporting error in IGS systems is reviewed. Using this technique, the error of commercially available IGS systems is reviewed.RECENT FINDINGS: The most commonly used IGS systems depend on the conformation of the skin, as opposed to relying on bone-implanted devices. For these systems, mean accuracies 2 mm or less are routinely reported. This finding is independent of fiducial markers (eg, proprietary headsets, skin-affixed markers, or laser scanning of skin surfaces). Techniques of fiducial localization and registration of CT scans to intraoperative anatomy are proprietary to each company. As such, there is great variability in reporting system specifications-particularly error of IGS systems. This lack of standardization makes comparison of one system to another difficult if not impossible.SUMMARY: Image-guided surgery systems commonly used in rhinology report mean accuracies of 2 mm or less. Surgeons must be aware that this value represents a mean of a distribution of errors. As such, 95% of the time error can be expected to be less than approximately 1.7 times its mean value. However, outliers (errors much larger and much smaller than the mean) may exist for each IGS intervention. As noted, IGS systems function to complement-not replace-knowledge of surgical anatomy.