A Mobile Computed Tomographic Scanner with Intraoperative and Intensive Care Unit Applications

Butler, William E.; Piaggio, Cristina M.; Constantinou, Christodoulos; Niklason, Loren T.; González, R. Gilberto; Cosgrove, G. Rees; Zervas, Nicholas T.

doi:10.1097/00006123-199806000-00064

Cited by 107 publications

(54 citation statements)

References 9 publications

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“…6,9) Intraoperative CT and MR imaging are easily integrated into navigation systems and provide excellent images of anatomical deformation in the brain. 5,15,26) However, these imaging techniques are limited by factors such as manpower, cost, and restricted surgical access. 2,7,24) US scanners have been used for intraoperative imaging for 20 years.…”

Section: Discussion I Problems Of Conventional Navigation Systemsmentioning

confidence: 99%

“…14,18,21,25) However, the accuracy of navigation systems based on preoperative imaging decreases with the progress of surgical manipulation due to a phenomenon called``brain shift,'' which is caused by various factors, including the effect of gravity on the brain, escape of cerebrospinal fluid, brain swelling, and surgical maneuvers. 7,8) Intraoperative imaging systems using computed tomography (CT) 5) or magnetic resonance (MR) imaging 15) have been introduced to counter the effects of brain shift. These intraoperative imaging systems allow update of the imaging data, but also require considerable time periods for operation.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Ohue

Kumon

Nagato

et al. 2010

Neurol. Med. Chir.(Tokyo)

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Image-guided neurosurgery using navigation systems is an essential tool to increase accuracy in brain tumor surgery. However, brain shift during surgery has remained problematic. The present study evaluated the utility of a new ultrasound (US)-linked navigation system for brain tumor surgery in 64 patients with intracranial tumors. The navigation system consisted of a StealthStation TM navigation system, a SonoNav TM system, and a standard US scanner. This system determines the orientation of the US images and reformats the images from preoperative computed tomography (CT) or magnetic resonance (MR) imaging to match the US images. The system was used intraoperatively to measure brain shift several times, using the results to guide tumor resection. US-linked navigation provided information regarding brain shift, and extent of tumor resection during surgery. Evaluation of brain shift was easily achieved in all patients, without using intraoperative CT or MR imaging. Accurate information regarding the true anatomical configuration of the patient could be obtained in all phases of the operation. Magnitude of brain shift increased progressively from pre-to post-resection and depended on the type of cranial structure. Integration of the US scanner with the navigation system allowed comparisons between the intraoperative US and preoperative images, thus improving interpretation of US images. The system also improved the rate of tumor resection by facilitating the detection of remnant tumor tissue. This US-linked navigation system provides information on brain shift, and improves the accuracy and utility of image-guided surgery.

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Section: Discussion I Problems Of Conventional Navigation Systemsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Ohue

Kumon

Nagato

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…It has scanning capabilities that allow for multiple windowing, high resolution contrasted study for soft tissue discrimination, CT angiography, and 3-D rendering capabilities. Opponent of this technology point out the risk of radiation exposure, but Butler et al showed that actual risk is quite low (7). Radiation dose report for our institutional 64 slice CT scanner is approximately 68 mGY per routine 5 mm slice head CT.…”

Section: Discussionmentioning

confidence: 93%

Intraoperative Computed Tomography/Angiography Guided Resection of Skull Base Lesions

Tran¹,

Yonas²

2013

Novel Frontiers of Advanced Neuroimaging

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“…6 The Tomoscan has been evaluated for its potential applications in emergency departments, departments of surgery, and ICU settings. [14][15][16][17][18] For cranial imaging, a clinical evaluation of this machine in comparison with conventional scanners demonstrated increased noise and artifacts, but the diagnostic value was no different from that of the comparison unit. 7 When scanning patients in locations in which space is limited, gantry motion allows 356 mm of scanning length, so a head scan can be obtained without removing the patient from his or her bed.…”

Section: Tomoscan Mmentioning

confidence: 99%

Review of Portable CT with Assessment of a Dedicated Head CT Scanner

Rumboldt¹,

Huda²,

All³

2009

AJNR Am J Neuroradiol

102

105

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SUMMARY:This article reviews a number of portable CT scanners for clinical imaging. These include the CereTom, Tomoscan, xCAT ENT, and OTOscan. The Tomoscan scanner consists of a gantry with multisection detectors and a detachable table. It can perform a full-body scanning, or the gantry can be used without the table to scan the head. The xCAT ENT is a conebeam CT scanner that is intended for intraoperative scanning of cranial bones and sinuses. The OTOscan is a multisection CT scanner intended for imaging in ear, nose, and throat settings and can be used to assess bone and soft tissue of the head. We also specifically evaluated the technical and clinical performance of the CereTom, a scanner designed specifically for neuroradiologic head imaging. The contrast performance of this scanner permitted the detection of 4-mm low-contrast lesions, and the limiting spatial resolution was 7 line pairs per centimeter. The measured volume of the CT dose index (CTDI vol ) for a standard head CT scan was 41 mGy (120 kV/14 mAs). All clinical images were of diagnostic quality, and the average patient effective dose was 1.7 mSv. We conclude that the CereTom portable CT scanner generates satisfactory clinical images at acceptable patient doses.

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A Mobile Computed Tomographic Scanner with Intraoperative and Intensive Care Unit Applications

Cited by 107 publications

References 9 publications

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Evaluation of Intraoperative Brain Shift Using an Ultrasound-Linked Navigation System for Brain Tumor Surgery

Intraoperative Computed Tomography/Angiography Guided Resection of Skull Base Lesions

Review of Portable CT with Assessment of a Dedicated Head CT Scanner

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