OBJECTIVES: The goal of this study was to evaluate the accuracy of the registration process and to identify potential sources of error during anterior cranial base surgery.
STUDY DESIGN AND SETTING: The registration accuracy of image guidance and the location of excluded fiducials were recorded prospectively from 50 endoscopic, anterior cranial base procedures in an academic university setting.
RESULTS: The mean error of initial registration was 2.8 mm (range, 1.4 to 7.1 mm). Following the exclusion of fiducials the mean error of registration was 1.6 mm (range, 0.6 to 3.7 mm). There was a significant improvement in the mean error rate from initial to final registration following the exclusion of fiducials (P < 0.0001). Posterior fiducials were excluded most often and anterior fiducials were excluded the least. Registration accuracy was similar for CT and MRI (P = 0.64).
CONCLUSIONS: The accuracy of the Stryker Image Guidance System is enhanced by the exclusion of individual fiducials with high registration errors.
SIGNIFICANCE: The exclusion of fiducials with high registration errors increases the accuracy of image guidance in anterior cranial base surgery.
Get full access to this article
View all access options for this article.
References
1.
ZeinrichSJTeboSASnyderman. Intraoperative stereotaxis for endoscopic sinus surgery: A technical review. In: MyersENKrauseCJBluestoneCD, editors. Advances in otolaryngology, head and neck surgery. St Louis: Mosby; 1997. pp 181–203
WiltfangJRupprechtSGanslandtO. Intraoperative image-guided surgery of the lateral and anterior skull base in patients with tumors or trauma. Skull Base2003;13:21–8
4.
HemlerPFNapelSSumanaweeraTS. Registration error quantification of a surface-based multimodality image fusion system. Med Phys1995;22:1049–56
5.
WestJBFitzpatrickMTomsSA. Fiducial point placement and the accuracy of point-based rigid body registration. Neuro-surgery2001;48:810–6
CarrauRLSnydermanCHCurtinHB. Computer assisted intraoperative navigation during skull base surgery. Am J Otolaryngol1996;17:95–101
8.
KlimekLAckeULubbenB. A passive marker based optical system for computer aided in otorhinolaryngology: Development and first clinical experiences. Laryngoscope1999;109:1509–15
9.
MetsonRGliklichRECosenzaM. A comparison of image guidance systems for sinus surgery. Laryngoscope1998;108:1164–70
10.
GrunertPMuller-ForellWDarabiK. Basic principles and clinical applications of neuronavigation and intraoperative computed tomography. Comp Aid Surg1998;3:166–73
11.
BarnettGHMillerDWWeisenbergerJ. Frameless stereotaxy with scalp-applied fiducial markers for brain biopsy procedures: Experience in 218 cases. J Neurosurg1999;91:569–76
12.
AmmiratiMGrossJDAmmiratiG. Comparison of registration accuracy of skin- and bone-implanted fiducials for frameless stereotaxis of the brain: A prospective study. Skull Base2002;12:125–30
13.
SiposEPTeboSAZinreichSJ. In vivo accuracy testing and clinical experience with the ISG Viewing Wand. Neurosurgery1996;39:194–202
