Development of a novel multi-modal surgical navigation system with the integration of three-dimensional cerebrovascular imaging data.

到目前为止，在神经外科领域，图像引导手术导航系统仅应用于脑肿瘤手术、立体定向活检和立体定向手术等有限的领域。本研究的目的是将手术导航系统的使用扩展到脑血管手术领域。首先，我们开发了将三维脑血管图像数据，如三维CT血管造影（3D-CTA），三维旋转血管造影（3D-RA）和三维超声血管造影（3D-UA）引入导航系统的基础技术，并在体模实验和临床环境中测量了三维配准的准确性。因此，配准误差为1- 2 mm，认为这足以应用于脑血管外科领域。此外，我们开发了三维脑血管图像引导手术导航系统，通过集成3D-CTA，3D-RA和3D-UA，可以实时更新配准，并评估配准的准确性。该导航系统中的配准误差约为2 mm，这被认为是临床应用可能的精度。

Thus far, in the field of neurosurgery, image-guided surgical navigation system has been used in limited field such as brain tumor surgery, stereotactic biopsy and stereotactic surgery. The aim of this study is to expand the use of the surgical navigation system to the field of cerebrovascular surgery. At first, we developed basic technology introducing three-dimensional cerebrovascular image data such as three-dimensional CT angiography (3D-CTA), three-dimensional rotational angiography (3D-RA) and three-dimensional ultrasonic angiography (3D-UA) into navigation system, and we measured the accuracy of registration three-dimensionally in phantom experiments and clinical setting. As a result, error in registration was 1-2mm, and this was considered to be sufficient accuracy to apply for the field of cerebrovascular surgery. In addition, we developed three-dimensional cerebrovascular image-guided surgical navigation system by which real-time update of registration became possible by integrating 3D-CTA, 3D-RA and 3D-UA, and evaluated the accuracy of registration. Error in registration in this navigation system was about 2 mm, and this was thought to be accuracy that clinical application is possible.