A Dedicated CT System for the Stereotactic Operating Room

Ld, Lunsford

doi:10.1159/000101625

Cited by 29 publications

(22 citation statements)

References 2 publications

(2 reference statements)

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“…In 1979, the first prototype, CT-compatible, stereotactic frame was developed [1], and in 1982, the first dedicated, intraoperative CT scanner (General Electric, Medical Systems, Milwaukee, Wisc., USA) was installed [2][3][4]. This scanner was upgraded 10 years later to a GE 9800 CT scanner.…”

confidence: 99%

“…In 1982 we installed a dedicated, ceiling-mounted, single-plane, adjustable fluoroscope in the operative suite [1][2][3][4]. Because of its high vertical height, this machine a All patients with AVMs treated by Gamma Knife underwent angiograms immediately after placement of the stereotactic head frame and immediately prior to the radiosurgical procedure.…”

Section: Intraoperative Fluoroscopymentioning

confidence: 99%

“…fellowship in Sweden, after which the hospital was persuaded to install a dedicated, intraoperative CT scanner for stereotactic surgery. In 1982, an intraoperative GE 8800 CT scanner (General Electric) became operational [2][3][4]. The surgical scanner position was reversed in order to enable full head access for surgery ( fig.…”

Section: Intraoperative Ctmentioning

confidence: 99%

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Brain Surgery with Image Guidance: Current Recommendations Based on a 20-Year Assessment

Lee

Lunsford

Subach

et al. 2000

Stereotact Funct Neurosurg

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Image guidance promotes safe and effective surgical management of a wide array of intracranial diseases. To better define the historical importance of image guidance and to assess the relative contribution of each imaging modality to the safety and efficacy of selected procedures, we reviewed our 20-year experience at a single institution. A retrospective review of our departmental surgical records was performed to identify patients who underwent brain surgery with image guidance between January 1979 and January 1999. We identified the use of intraoperative fluoroscopy , endoscopy, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and angiography in 7,388 patients. During this 20-year interval, advances in neuroimaging were translated into the operating room environment. Fluoroscopic guidance received the highest overall rating and was deemed critical for the performance of successful transsphenoidal surgery (n = 436) and effective percutaneous trigeminal neuralgia management (n = 1,121). Ultrasound and angiography both had limited roles; the latter was important to successful outcomes in 64 patients undergoing aneurysm management (n = 64) and arteriovenous malformation Gamma Knife radiosurgery (n = 786). Endoscopy also had a small role but had limited cost. Beginning in 1982, a dedicated operating room CT scanner was used during both morphologic and functional stereotactic surgery (n = 1,749). After 1986, MRI was used increasingly in the management of selected functional and tumor cases (n = 337); despite great versatility for patients undergoing Gamma Knife radiosurgery, the costs were relatively high. Frameless neuronavigation (n = 263) had excellent versatility and was relatively low in cost. During the last 20 years, image guidance techniques have facilitated minimally invasive brain surgery at our institution. The relative merits of all these imaging tools depended mostly on their versatility and relative costs. Major centers currently contemplating the incorporation of image guidance into routine brain surgery need not reproduce our own learning curve.

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confidence: 99%

Section: Intraoperative Fluoroscopymentioning

confidence: 99%

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Brain Surgery with Image Guidance: Current Recommendations Based on a 20-Year Assessment

Lee

Lunsford

Subach

et al. 2000

Stereotact Funct Neurosurg

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“…Beginning in 1979, it was adopted by six different stereotactic frames to enable image-guided surgery and radiosurgery in conjunction with computed tomography (CT), magnetic resonance (MR), and positron emission tomography (PET) . Regarding these six stereotactic frames, the Riechert-Mundinger frame that was adapted to CT at Duke University [9,16] and the Pfizer frame that was constructed in collaboration with the Univeristy of Pittsburgh [5,10,27] were used at only those institutions. The Kelly-Goerss [8,12] frame was the first to be adapted to PET [32].…”

Section: Introductionmentioning

confidence: 99%

The Mathematics of Three or More N-Localizers for Stereotactic Neurosurgery

Brown¹

2014

Cureus

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“…Interest in the area of volumetric resection of intracranial lesions has been present since the introduction of volumetric imaging itself [2,3] . The claim that tumors can be more aggressively resected with less damage to adjacent brain tissue has been supported by large clinical series from several authors [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Volumetric Resection Using the SurgiScope<sup>®</sup>: A Quantitative Accuracy Analysis of Robot-Assisted Resection

Amin¹,

Lunsford²

2004

Stereotact Funct Neurosurg

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Objective: This study evaluates the hypothesis that current image guidance technology can effectively guide the resection of a predefined intracranial volume from the surgical field in the absence of a visually distinct lesion. Methods: An in vitro model was constructed to simulate the resection of a visually nondistinct lesion. Preoperative CT was acquired, and the lesion was resected from the model with a cavitating ultrasonic aspirator using image guidance information provided by the SurgiScope^® system. Results: On average, 77% of the 8.2-cm³ surgical target volume was removed. Over a series of 5 trials, the underresection volume was 1.9 cm³ on average or 23% of the surgical target volume. The overresection volume was 1.0 cm³ on average, representing 13% of the surgical target volume. Conclusion: This in vitro model developed to evaluate the accuracy and limitations of our current image guidance technology provided quantitative data to demonstrate the potential for robotic navigation systems to guide the volumetric resection in the absence of visual differentiation between the lesion and the surrounding brain.

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A Dedicated CT System for the Stereotactic Operating Room

Cited by 29 publications

References 2 publications

Brain Surgery with Image Guidance: Current Recommendations Based on a 20-Year Assessment

Brain Surgery with Image Guidance: Current Recommendations Based on a 20-Year Assessment

The Mathematics of Three or More N-Localizers for Stereotactic Neurosurgery

Volumetric Resection Using the SurgiScope<sup>®</sup>: A Quantitative Accuracy Analysis of Robot-Assisted Resection

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