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Laser-assisted flat-detector CT-guided intracranial access

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Flat-detector CT can be integrated with C-arm fluoroscopy for CT-guided neurosurgical and endovascular procedures. We studied the accuracy of this technique with laser assistance in targeting intracranial lesions in a cranial model.

Methods

An acrylic scale-model skull containing foam parenchyma was embedded with 2.16-mm-diameter targets. A flat-detector CT was acquired and registered to the skull’s position. Ten targets were accessed with biopsy needles under fluoroscopic guidance, flat-detector CT overlay, and laser assistance. Accuracy was measured from the needle tip to the target center using flat-detector CT.

Results

Ten targets were accessed successfully using XperGuide software. Needles were placed within 1.30 \(\pm \) 0.63 mm of target isocenter. Accuracy did not vary by entry site, operator, location, or lesion depth.

Conclusions

Laser-assisted flat-detector CT-guided targeting of all intracranial targets was successful with excellent accuracy. This technique can be applied to other minimally invasive neurosurgical procedures.

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Author information

Author notes

    Authors and Affiliations

    1. Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA

      Daniel L. Cooke

    2. Department of Neurological Surgery, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359924, Seattle, WA, 98104-2499, USA

      Michael R. Levitt, Louis J. Kim, Danial K. Hallam, Laligam N. Sekhar & Basavaraj V. Ghodke

    3. Department of Radiology, University of Washington, Seattle, WA, USA

      Michael R. Levitt, Louis J. Kim, Danial K. Hallam & Basavaraj V. Ghodke

    Authors
    1. Daniel L. Cooke
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    2. Michael R. Levitt
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    3. Louis J. Kim
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    4. Danial K. Hallam
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    5. Laligam N. Sekhar
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    6. Basavaraj V. Ghodke
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    Correspondence to Michael R. Levitt.

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    This study was not funded by any grant or outside entity.

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    The authors declare that they have no conflict of interest.

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    This article does not contain any studies with human participants or animals performed by any of the authors.

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    This article does not contain patient data.

    Additional information

    Daniel L. Cooke and Michael R. Levitt contributed equally to this work.

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    Cooke, D.L., Levitt, M.R., Kim, L.J. et al. Laser-assisted flat-detector CT-guided intracranial access. Int J CARS 11, 467–472 (2016). https://doi.org/10.1007/s11548-015-1271-5

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    • DOI: https://doi.org/10.1007/s11548-015-1271-5

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