Intraoperative Cone‐beam CT for Guidance of Temporal Bone Surgery

Rafferty, Mark; Siewerdsen, Jeffrey H.; Chan, Yvonne; Daly, Michael J.; Moseley, D; Jaffray, David A.; Irish, Jonathan C.

doi:10.1016/j.otohns.2005.12.007

Cited by 77 publications

(61 citation statements)

References 14 publications

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“…Comparatively low dosing requirements and a relatively compact design have also led to intense interest in surgical planning and intraoperative CBCT applications, particularly in the head and neck but also in spinal, thoracic, abdominal, and orthopedic procedures. [7][8][9][10][11] Diagnostic applications in CT mammography and head and neck imaging are also under evaluation. [12][13][14] The technical and clinical considerations pertaining to CBCT imaging in many of these applications have been the subjects of several recent reviews.…”

Section: Onebeam Ct (Cbct) Is An Advancement In Ct Imagingmentioning

confidence: 99%

“…In the head and neck region, a premium is placed on discriminating fine anatomic detail in territories where the vascular and bony structural anatomy is particularly complex. 8 Potential applications in sinus, temporal bone, and skull base imaging have been explored, as discussed below. Figures 3, 4, 5, and 6 depict head and neck CBCT studies visualizing the paranasal sinuses; temporal bones; maxillary sinus floor and alveolar process of the maxilla; and orbital floors respectively.…”

Section: Endodonticsmentioning

confidence: 99%

“…Specific applications have been explored, including postprocedural middle and inner ear implant evaluation, visualization of the reuniting duct in the inner ear, and intraoperative temporal bone surgical guidance. 8 Preliminary evaluation of an experimental CBCT system for general temporal bone diagnostic imaging was performed by Gupta et al 12 on a small series of partially manipulated cadaveric specimens. They found that observer scores of the quality of structural visualization with CBCT were significantly higher compared with scores for MDCT.…”

Section: Sinus Imaging/frontal Recessmentioning

confidence: 99%

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Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Miracle¹,

Mukherji²

2009

AJNR Am J Neuroradiol

293

204

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SUMMARY: Conebeam x-ray CT (CBCT) is being increasingly used for point-of-service head and neck and dentomaxillofacial imaging. This technique provides relatively high isotropic spatial resolution of osseous structures with a reduced radiation dose compared with conventional CT scans. In this second installment in a 2-part review, the clinical applications in the dentomaxillofacial and head and neck regions will be explored, with particular emphasis on diagnostic imaging of the sinuses, temporal bone, and craniofacial structures. Several controversies surrounding the emergence of CBCT technology will also be addressed. C onebeam CT (CBCT) is an advancement in CT imagingthat has begun to emerge as a potentially low-dose crosssectional technique for visualizing bony structures in the head and neck. The physical principles, image quality parameters, and technical limitations relevant to CBCT imaging were discussed in Part 1 of this 2-part series. The second part presented here will highlight the evidence related to CBCT applications in head and neck as well as dentomaxillofacial imaging. Controversial aspects of this technology will also be addressed, including limitations in image quality and its often officebased operational model.CBCT was first adapted for potential clinical use in 1982 at the Mayo Clinic Biodynamics Research Laboratory. 1 Initial interest focused primarily on applications in angiography in which soft-tissue resolution could be sacrificed in favor of high temporal and spatial-resolving capabilities. Since that time, several CBCT systems have been developed for use both in the interventional suite and for general applications in CT angiography. 2,3 Exploration of CBCT technologies for use in radiation therapy guidance began in 1992, 4,5 followed by integration of the first CBCT imaging system into the gantry of a linear accelerator in 1999. 6 The first CBCT system became commercially available for dentomaxillofacial imaging in 2001 (NewTom QR DVT 9000; Quantitative Radiology, Verona, Italy). Comparatively low dosing requirements and a relatively compact design have also led to intense interest in surgical planning and intraoperative CBCT applications, particularly in the head and neck but also in spinal, thoracic, abdominal, and orthopedic procedures. [7][8][9][10][11] Diagnostic applications in CT mammography and head and neck imaging are also under evaluation. 12-14 The technical and clinical considerations pertaining to CBCT imaging in many of these applications have been the subjects of several recent reviews. [15][16][17][18][19] The recent review by Dörfler et al 16 of the neurointerventional applications of CBCT is of particular interest to the field of neuroradiology.The discussion below will focus on the diagnostic and treatment-planning applications of CBCT in dentomaxillofacial and head and neck imaging. Commercially available CBCT systems for dentomaxillofacial imaging include the CB MercuRay and CB Throne (Hitachi Medical, Kashiwi-shi, Chiba-ken, Japan), 3D Accuitomo products (J. Mor...

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Section: Onebeam Ct (Cbct) Is An Advancement In Ct Imagingmentioning

confidence: 99%

Section: Endodonticsmentioning

confidence: 99%

Section: Sinus Imaging/frontal Recessmentioning

confidence: 99%

See 1 more Smart Citation

Conebeam CT of the Head and Neck, Part 2: Clinical Applications

Miracle¹,

Mukherji²

2009

AJNR Am J Neuroradiol

293

204

View full text Add to dashboard Cite

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“…[1][2][3][4] Implementation of CBCT on a mobile isocentric C-arm has been recently investigated for 3D intraoperative guidance. [5][6][7][8][9][10][11][12][13][14][15][16] Gantry rotation for such systems is subject to geometric nonidealities, with motion of the x-ray source and detector differing significantly from a simple circular orbit due, for example, to gravity-induced mechanical flex. 2 CBCT reconstruction algorithms that assume a circular source-detector trajectory ͑e.g., FDK filtered backprojection 17 ͒ therefore require an accurate calibration method to account for geometric nonidealities.…”

Section: Introductionmentioning

confidence: 99%

“…The imaging system was a mobile isocentric C-arm ͑Siemens PowerMobil͒ modified in collaboration with Siemens Medical Solutions ͑Erlangen, Germany͒. [5][6][7] This prototype has been shown to offer sub-mm 3D spatial resolution and softtissue visibility and is currently being deployed in preclinical applications across a broad range of image-guided interventions, including head and neck surgery, [8][9][10][11][12][13] orthopedics, 14,15 spine surgery, 7 thoracic surgery, breast surgery, and brachytherapy. 6 The reproducibility, sensitivity, and tolerance of geometric calibration were evaluated in terms of spatial resolution, image artifacts, and bony anatomy visualization in an anthropomorphic head phantom.…”

Section: Introductionmentioning

confidence: 99%

Geometric calibration of a mobile C‐arm for intraoperative cone‐beam CT

et al. 2008

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A geometric calibration method that determines a complete description of source-detector geometry was adapted to a mobile C-arm for cone-beam computed tomography ͑CBCT͒. The non-iterative calibration algorithm calculates a unique solution for the positions of the sourceand detector rotation angles ͑ , , ͒ based on projections of a phantom consisting of two plane-parallel circles of ball bearings encased in a cylindrical acrylic tube. The prototype C-arm system was based on a Siemens PowerMobil modified to provide flat-panel CBCT for image-guided interventions. The magnitude of geometric nonidealities in the source-detector orbit was measured, and the short-term ͑ϳ4 h͒ and long-term ͑ϳ6 months͒ reproducibility of the calibration was evaluated. The C-arm exhibits large geometric nonidealities due to mechanical flex, with maximum departures from the average semicircular orbit of ⌬U o = 15.8 mm and ⌬V o = 9.8 mm ͑for the piercing point͒, ⌬X and ⌬Y =6-8 mm and ⌬Z =1 mm ͑for the source and detector͒, and ⌬ ϳ 2.9°, ⌬ ϳ 1.9°, and ⌬ ϳ 0.8°͑for the detector tilt/rotation͒. Despite such significant departures from a semicircular orbit, these system parameters were found to be reproducible, and therefore correctable by geometric calibration. Short-term reproducibility was Ͻ0.16 mm ͑subpixel͒ for the piercing point coordinates, Ͻ0.25 mm for the source-detector X and Y, Ͻ0.035 mm for the source-detector Z, and Ͻ0.02°for the detector angles. Long-term reproducibility was similarly high, demonstrated by image quality and spatial resolution measurements over a period of 6 months. For example, the full-width at half-maximum ͑FWHM͒ in axial images of a thin steel wire increased slightly as a function of the time ͑⌬͒ between calibration and image acquisition: FWHM= 0.62, 0.63, 0.66, 0.71, and 0.72 mm at ⌬ = 0 s, 1 h, 1 day, 1 month, and 6 months, respectively. For ongoing clinical trials in CBCT-guided surgery at our institution, geometric calibration is conducted monthly to provide sufficient three-dimensional ͑3D͒ image quality while managing time and workflow considerations of the calibration and quality assurance process. The sensitivity of 3D image quality to each of the system parameters was investigated, as was the tolerance to systematic and random errors in the geometric parameters, showing the most sensitive parameters to be the piercing point coordinates

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