Biomodel-guided Stereotaxy

Biomodel-guided Stereotaxy AbstractOBJECTIVETo simplify the practice of stereotactic surgery by using an original method, apparatus, and solid anatomic replica for trajectory planning and to validate the method and apparatus in a laboratory and clinical trial.METHODSThe patient is marked with fiducials and scanned by using computed tomography or magnetic resonance imaging. The three-dimensional data are converted to a format acceptable to stereolithography. Stereolithogra- phy uses a laser to polymerize photosensitive resin into a solid plastic model (biomodel). Stereolithography can replicate blood vessels, soft tissue, tumor, and bone accurately (<0.8 mm). A stereotactic apparatus is referenced to fiducials replicated in the biomodel. The trajectory for the intervention is determined and saved. The apparatus is attached to the patient fiducials, and the intervention is replicated.RESULTSThree types of apparatus (template, Brown-Roberts-Wells frame, and D'Urso frame) were tested on phantoms and patients requiring the excision/biopsy of tumors. The localization errors determined from the phantom studies were template, 0.82 mm; Brown-Roberts-Wells frame, 1.17 mm; and D'Urso frame, 0.89 mm. The surgeons reported that clinical use of the template and D'Urso frame was accurate and ergonomic. The Brown-Roberts-Wells frame was more difficult to use and somewhat inaccurate.CONCLUSIONBiomodel-guided stereotaxy has significant advantages. It is performed quickly; it is based on simple, intuitive methodology; it enhances visualization of anatomy and trajectory planning; it enhances patient understanding; it uses inexpensive equipment; it does not require rigid head fixation; and it has greater versatility than known techniques. Disadvantages are biomodel cost and a manufacturing time of 12 to 24 hours. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Biomodel-guided Stereotaxy

Paul S. D'Urso, Ph.D., Bruce I. Hall, F.R .A .C .S ., R. Leigh Atkinson, F.R .A .C .S., Michael J. Weidmann, F.R .A .C .S ., Michael J. Redmond, F.R.A .C .S. Department of Neurological Sciences, Princess Alexandra Hospital, Brisbane, Australia OBJECTIVES: T o sim p lify th e p ra c tic e o f s te re o ta c tic surgery by using an o rig in a l m e t h o d , a p p a ra tu s , a n d solid anatomic re p lic a fo r tr a je c to r y p la n n in g an d to v a lid a te th e m e t h o d a n d a p p a ra tu s in a la b o r a to r y a n d c lin ic a l trial. M E T H O D S : T h e p a t i e n t is m a r k e d w i t h fid u c ia ls a n d s c a n n e d b y using c o m p u t e d t o m o g r a p h y o r m a g n e t ic resonance im a g in g . T h e t h r e e - d i m e n s i o n a l d a ta a r e c o n v e r t e d to a f o r m a t a c c e p t a b l e to s t e r e o l i t h o g r a p h y . Stereolithogra- p h y uses a laser to p o l y m e r i z e p h o to s e n s itiv e resin in to a so lid p la s tic m o d e l ( b i o m o d e l ) . S te re o lith o g ra p h y can r e p l ic a t e b lo o d vessels, soft tissue, t u m o r , a n d b o n e a c c u r a t e l y ( < 0 . 8 m m ) . A s t e r e o t a c t i c a p p a r a t u s is referenced to fid u c ia ls r e p l ic a t e d in t h e b i o m o d e l . T h e t r a j e c t o r y f o r t h e i n t e r v e n t i o n is d e t e r m i n e d a n d s a v e d . T h e apparatus is a t t a c h e d to th e p a t i e n t fid u c ia ls , a n d t h e i n t e r v e n t i o n is r e p l i c a t e d . RESULTS: T h r e e ty p e s o f a p p a r a t u s ( t e m p l a t e , B r o w n - R o b e r t s - W e l l s f r a m e , a n d D ' U r s o f r a m e ) w e r e tested on p h a n to m s a n d p a tie n ts r e q u i r i n g th e e x c is io n /b io p s y o f t u m o r s . T h e l o c a l i z a t i o n e r r o r s d e t e r m i n e d from the p h a n t o m studies w e r e t e m p l a t e , 0 . 8 2 m m ; B r o w n - R o b e r t s - W e l l s f r a m e , 1...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199905000-00080
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVETo simplify the practice of stereotactic surgery by using an original method, apparatus, and solid anatomic replica for trajectory planning and to validate the method and apparatus in a laboratory and clinical trial.METHODSThe patient is marked with fiducials and scanned by using computed tomography or magnetic resonance imaging. The three-dimensional data are converted to a format acceptable to stereolithography. Stereolithogra- phy uses a laser to polymerize photosensitive resin into a solid plastic model (biomodel). Stereolithography can replicate blood vessels, soft tissue, tumor, and bone accurately (<0.8 mm). A stereotactic apparatus is referenced to fiducials replicated in the biomodel. The trajectory for the intervention is determined and saved. The apparatus is attached to the patient fiducials, and the intervention is replicated.RESULTSThree types of apparatus (template, Brown-Roberts-Wells frame, and D'Urso frame) were tested on phantoms and patients requiring the excision/biopsy of tumors. The localization errors determined from the phantom studies were template, 0.82 mm; Brown-Roberts-Wells frame, 1.17 mm; and D'Urso frame, 0.89 mm. The surgeons reported that clinical use of the template and D'Urso frame was accurate and ergonomic. The Brown-Roberts-Wells frame was more difficult to use and somewhat inaccurate.CONCLUSIONBiomodel-guided stereotaxy has significant advantages. It is performed quickly; it is based on simple, intuitive methodology; it enhances visualization of anatomy and trajectory planning; it enhances patient understanding; it uses inexpensive equipment; it does not require rigid head fixation; and it has greater versatility than known techniques. Disadvantages are biomodel cost and a manufacturing time of 12 to 24 hours.

Journal

NeurosurgeryOxford University Press

Published: May 1, 1999

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