Frameless stereotaxic integration of CT imaging data: accuracy and initial applications.

Zinreich, S J; Tebo, Scot A.; Long, Donlin M.; Brem, Henry; Mattox, Douglas E.; Loury, M. E.; Kolk, Craig A. Vander; Koch, Wayne M.; Kennedy, David W.; Bryan, R. Nick

doi:10.1148/radiology.188.3.8351341

Cited by 237 publications

(95 citation statements)

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“…Zinreich et al [20] examined the mechanical and application accuracy of the ISG Viewing Wand using CT scanning with 4-mm slice thickness and 3-mm table increments. The technical accuracy was checked using a plexiglas phantom and measuring the localization error.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Application Accuracy of Neuronavigation Systems

Steinmeier¹,

Rachinger²,

Kaus³

et al. 2000

Stereotact Funct Neurosurg

116

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Objective: The overall accuracy of neuronavigation systems may be influenced by (1) the technical accuracy, (2) the registration process, (3) voxel size and/or distortion of image data and (4) intraoperative events. The aim of this study was to test the influence of the registration and imaging modality on the accuracy. Methods: A plexiglas phantom with 32 rods was taken for navigation targeting. Sixteen fiducials were attached to the surface of the phantom forming two different attachment patterns (clustered vs. diffusely scattered). This model was scanned by MRI and CT (1-mm slices). Registration was performed using different numbers and attachment patterns of the fiducials. Using CT or MRI, the localization error was measured in image space as the Euclidean distance between targets defined in image space and those detected in the physical space. Accuracy was measured with two commercial systems, the Zeiss MKM and the StealthStation. Results: The mean localization error varied between 1.59 ± 0.29 mm (MKM, 8 scattered fiducials, CT scanning) and 3.86 ± 2.19 mm (MKM, 4 clustered fiducials, MRI). The worst localization error was 9.5 mm (MKM). In case of an optimal registration, the 95th percentile for the localization error was 2.2 (MKM) and 2.75 mm (StealthStation). The imaging modality has only minor influence on the localization error, with CT increasing accuracy minimally. Both the fiducial number and the attachment pattern critically influence the localization error: 8 fiducials and a generalized attachment pattern increase the accuracy significantly. No correlation between the calculated registration accuracy and the measured localization accuracy was found. Conclusion: The application accuracy of different neuronavigation systems critically depends on the registration. The calculated registration accuracy provided by the system does not correspond to the localization error found in reality. The accuracy of frameless neuronavigation systems is comparable to that of classical frame-based stereotactic devices.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing the Application Accuracy of Neuronavigation Systems

Steinmeier¹,

Rachinger²,

Kaus³

et al. 2000

Stereotact Funct Neurosurg

116

View full text Add to dashboard Cite

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“…Recently Balachandran 32,33 and Fitzpatrick 10 have introduced the Target Localization Error (TLE), the error associated with the physical localization of a locus on a patient (a marker, a screw, or an anatomical feature).This yields an overall estimate of the application error of clinical navigation in quadrature, the Total Target Error, TTE 10 , of (4) Here <TLE 2 >, <FLE 2 >, and <TRE 2 > are assumed to be independent random variables. TRE(r) with anisotropic noise covariance 27 can be predicted as (5) δ ij is the Kronecker delta, ε the smallness parameter of the perturbation-theoretic approach, are the components of the FLE covariance matrix Σ FLE , r i are the coordinates of a point r expressed in the principal axes coordinate system of the fiducials; are the i-th singular values of the fiducial configuration in the principal axes.…”

Section: Europe Pmc Funders Author Manuscriptsmentioning

confidence: 99%

Quantitative error analysis for computer assisted navigation: A feasibility study

et al. 2013

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Purpose-The benefit of computer-assisted navigation depends on the registration process, at which patient features are correlated to some preoperative imagery. The operator-induced uncertainty in localizing patient features -the User Localization Error (ULE) -is unknown and most likely dominating the application accuracy. This initial feasibility study aims at providing first data for ULE with a research navigation system. Methods-Active optical navigation was done in CT-images of a plastic skull, an anatomic specimen (both with implanted fiducials) and a volunteer with anatomical landmarks exclusively. Each object was registered ten times with 3, 5, 7, and 9 registration points. Measurements were taken at 10 (anatomic specimen and volunteer) and 11 targets (plastic skull). The active NDI Polaris system was used under ideal working conditions (tracking accuracy 0.23 mm root mean square, RMS; probe tip calibration was 0.18 mm RMS. Variances of tracking along the principal directions were measured as 0.18 mm 2 , 0.32 mm 2 , and 0.42 mm 2 . ULE was calculated from predicted application accuracy with isotropic and anisotropic models and from experimental variances, respectively.Results-The ULE was determined from the variances as 0.45 mm (plastic skull), 0.60 mm (anatomic specimen), and 4.96 mm (volunteer). The predicted application accuracy did not yield consistent values for the ULE.The authors declare not to have any conflict of interest. Europe PMC Funders GroupAuthor Manuscript Med Phys. Author manuscript; available in PMC 2013 July 03. Europe PMC Funders Author Manuscripts Europe PMC Funders Author ManuscriptsConclusions-Quantitative data of application accuracy could be tested against prediction models with iso-and anisotropic noise models and revealed some discrepancies. This could potentially be due to the facts that navigation and one prediction model wrongly assume isotropic noise (tracking is anisotropic), while the anisotropic noise prediction model assumes an anisotropic registration strategy (registration is isotropic in typical navigation systems). The ULE data are presumably the first quantitative values for the precision of localizing anatomical landmarks and implanted fiducials. Submillimetric localization is possible for implanted screws; anatomic landmarks are not suitable for high-precision clinical navigation.

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“…with the patient's position in the OR (Peters et al, 1996). This can be done using a stereotactic frame (Kelly, 1986), or with frameless registration systems (Zamorano et al, 1992;Zinreich et al, 1993;Grimson et al, 1996). Af-(CSF) leakage cause a gravitational shift that is due to the disappearance of tension and pressure forces at the brain and ventricular boundaries (Bucholz et al, 1997;Hill et al, 1998;Maurer et al, 1998;Nabavi et al, 2001).…”

Section: Role Of Registration During Surgerymentioning

confidence: 99%