High-performance intraoperative cone-beam CT on a mobile C-arm: an integrated system for guidance of head and neck surgery

@inproceedings{Siewerdsen2009HighperformanceIC,
  title={High-performance intraoperative cone-beam CT on a mobile C-arm: an integrated system for guidance of head and neck surgery},
  author={Jeffrey H. Siewerdsen and Michael J. Daly and Harley H.L. Chan and Sajendra Nithiananthan and N. Hamming and Kristy K. Brock and Jonathan C. Irish},
  booktitle={Medical Imaging},
  year={2009}
}
A system for intraoperative cone-beam CT (CBCT) surgical guidance is under development and translation to trials in head and neck surgery. The system provides 3D image updates on demand with sub-millimeter spatial resolution and soft-tissue visibility at low radiation dose, thus overcoming conventional limitations associated with preoperative imaging alone. A prototype mobile C-arm provides the imaging platform, which has been integrated with several novel subsystems for streamlined… 
Fusion of intraoperative cone-beam CT and endoscopic video for image-guided procedures
Methods for accurate registration and fusion of intraoperative cone-beam CT (CBCT) with endoscopic video have been developed and integrated into a system for surgical guidance that accounts for
Clinical implementation of intraoperative cone-beam CT in head and neck surgery
TLDR
Clinical trial deployment suggests a role for intraoperative CBCT in guiding complex head and neck surgical tasks, including planning mandible and maxilla resection margins, guiding subcranial and endonasal approaches to skull base tumours, and verifying maxillofacial reconstruction alignment.
Mobile C-arm cone-beam CT for guidance of spine surgery: image quality, radiation dose, and integration with interventional guidance.
TLDR
Intraoperative CBCT using a high-performance mobile C-arm prototype demonstrates image quality suitable to guidance of spine surgery, with task-specific protocols providing an important basis for minimizing radiation dose, while maintaining image quality sufficient for surgical guidance.
Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance.
TLDR
Intraoperative CBCT using a high-performance mobile C-arm prototype demonstrates image quality suitable to guidance of spine surgery, with task-specific protocols providing an important basis for minimizing radiation dose, while maintaining image quality sufficient for surgical guidance.
High-accuracy 3D image-based registration of endoscopic video to C-arm cone-beam CT for image-guided skull base surgery
TLDR
A new image-based video registration method has been developed to overcome the limitations of conventional tracker-based registration of endoscopic video to preoperative CT, providing high-accuracy registration of video to the surgical scene and more confident visualization of target and normal tissues within up-to-date images.
A clinical pilot study of a modular video-CT augmentation system for image-guided skull base surgery
TLDR
A practical video augmentation system for endoscopic skull base surgery translated to use in a clinical study with a practical system with a modular design that can be applied to other endoscopic surgeries, including orthopedic, abdominal, and thoracic procedures.
Tracker-on-C for cone-beam CT-guided surgery: evaluation of geometric accuracy and clinical applications
TLDR
The proposed configuration streamlines the integration of C-arm CBCT with realtime tracking and demonstrated utility in a spectrum of image-guided interventions (e.g., spine surgery) benefiting from improved accuracy, enhanced visualization, and reduced radiation exposure.
Tracker-onC for Cone-Beam CT-Guided Surgery : Evaluation of Geometric Accuracy and Clinical Applications
TLDR
The proposed configuration streamlines the integration of C-arm CBCT with realtime tracking and demonstrated utility in a spectrum of image-guided interventions (e.g., spine surgery) benefiting from improved accuracy, enhanced visualization, and reduced radiation exposure.
Accurate 3D-reconstruction and -navigation for high-precision minimal-invasive interventions
TLDR
This thesis contributes new methods to enhance the CBCT reconstruction quality by addressing two main reconstruction artifacts: the misalignment artifacts caused by mechanical inaccuracies, and the metal-artifacts caused by the presence of metal objects in the scanned region.
An electromagnetic “Tracker-in-Table” configuration for X-ray fluoroscopy and cone-beam CT-guided surgery
TLDR
The open frame of the WFG offers a potentially valuable configuration for electromagnetic trackers in image-guided surgery applications that are based on X-ray fluoroscopy and/or CBCT and offers increased depth (z-direction) FOV.
...
...

References

SHOWING 1-10 OF 40 REFERENCES
Intraoperative cone-beam CT for guidance of head and neck surgery: Assessment of dose and image quality using a C-arm prototype.
TLDR
The prototype C-arm demonstrates CBCT image quality sufficient for guidance of head and neck procedures based on soft-tissue and bony anatomy at dose levels low enough for repeat intraoperative imaging, with total dose over the course of the procedure comparable to or less than the effective dose of a typical diagnostic CT of the head.
Cone-beam computed tomography on a mobile C-arm: novel intraoperative imaging technology for guidance of head and neck surgery.
TLDR
Intraoperative CBCT quantifiably improved surgical performance in all excision tasks and significantly increased surgical confidence, particularly for radical excison tasks in proximity to critical normal structures.
Volume CT with a flat-panel detector on a mobile, isocentric C-arm: pre-clinical investigation in guidance of minimally invasive surgery.
TLDR
The intraoperative cone-beam CT images were sufficient for guidance of needles and catheters with respect to bony anatomy and improved surgical performance and confidence through 3D visualization and verification of transpedicular trajectories and tool placement.
Multimode C-arm fluoroscopy, tomosynthesis, and cone-beam CT for image-guided interventions: from proof of principle to patient protocols
TLDR
The C-arm system is currently being deployed in patient protocols ranging from brachytherapy to chest, breast, spine, and head and neck surgery, with the potential for improved surgical performance up to a factor of 2 increase in challenging surgical target excisions.
Intraoperative Cone-beam CT for Guidance of Temporal Bone Surgery
  • M. Rafferty, J. Siewerdsen, J. Irish
  • Medicine, Physics
    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 2006
Intraoperative cone-beam CT for image-guided tibial plateau fracture reduction
  • A. Khoury, J. Siewerdsen, D. Jaffray
  • Medicine, Physics
    Computer aided surgery : official journal of the International Society for Computer Aided Surgery
  • 2007
TLDR
A mobile isocentric C-arm was modified in the laboratory to include a large-area flat-panel detector providing multi-mode fluoroscopy and cone-beam CT (CBCT) imaging, offering superior image quality, increased field of view, higher spatial resolution, and soft-tissue visibility.
Intraoperative cone-beam CT for image-guided tibial plateau fracture reduction.
TLDR
A mobile isocentric C-arm was modified in the laboratory in collaboration with Siemens Medical Solutions to include a large-area flat-panel detector providing multi-mode fluoroscopy and cone-beam CT (CBCT) imaging, offering superior image quality, increased field of view, higher spatial resolution, and soft-tissue visibility.
Image quality and localization accuracy in C-arm tomosynthesis-guided head and neck surgery.
The image quality and localization accuracy for C-arm tomosynthesis and cone-beam computed tomography (CBCT) guidance of head and neck surgery were investigated. A continuum in image acquisition was
Flat-panel cone-beam CT: a novel imaging technology for image-guided procedures
TLDR
The performance of flat-panel cone-beam CT in relation to numerous constraints and requirements, including time (i.e., speed of image acquisition), dose, and field-of-view, is examined.
Geometric calibration of a mobile C-arm for intraoperative cone-beam CT.
TLDR
The sensitivity of 3D image quality to each of the system parameters was investigated, as was the tolerance to systematic and random errors in the geometric parameters, showing the most sensitive parameters to be the piercing point coordinates and in-plane positions of the source and detector and detector.
...
...