Cone-beam CT with a flat-panel detector on a mobile C-arm: preclinical investigation in image-guided surgery of the head and neck

J. H. Siewerdsen; Y. Chan M.D.; M. A. Rafferty M.D.; D. J. Moseley; D. A. Jaffray; J. C. Irish M.D.

doi:10.1117/12.595690

12 April 2005 Cone-beam CT with a flat-panel detector on a mobile C-arm: preclinical investigation in image-guided surgery of the head and neck

J. H. Siewerdsen, Y. Chan M.D., M. A. Rafferty M.D., D. J. Moseley, D. A. Jaffray, J. C. Irish M.D.

Author Affiliations +

Proceedings Volume 5744, Medical Imaging 2005: Visualization, Image-Guided Procedures, and Display; (2005) https://doi.org/10.1117/12.595690
Event: Medical Imaging, 2005, San Diego, California, United States

Abstract

A promising imaging platform for combined low-dose fluoroscopy and cone-beam CT (CBCT) guidance of interventional procedures has been developed in our laboratory. Based on a mobile isocentric C-arm (Siemens PowerMobil) incorporating a high-performance flat-panel detector (Varian PaxScan 4030CB), the system demonstrates sub-mm 3D spatial resolution and soft-tissue visibility with field of view sufficient for head and body sites. For pre-clinical studies in head neck tumor surgery, we hypothesize that the 3D intraoperative information provided by CBCT permits precise, aggressive techniques with improved avoidance of critical structures. The objectives include: 1) quantify improvement in surgical performance achieved with CBCT guidance compared to open and endoscopic techniques; and 2) investigate specific, challenging surgical tasks under CBCT guidance. Investigations proceed from an idealized phantom model to cadaveric specimens. A novel surgical performance evaluation method based on statistical decision theory is applied to excision and avoidance tasks. Analogous to receiver operating characteristic (ROC) analysis in medical imaging, the method quantifies surgical performance in terms of Lesion-Excised (True-Positve), Lesion-Remaining (False-Negative), Normal-Excised (False-Positive), and Normal-Remaining (True-Negative) fractions. Conservative and aggressive excision and avoidance tasks are executed in 12 cadaveric specimens with and without CBCT guidance, including: dissection through dura, preservation of posterior lamina, ethmoid air cells removal, exposure of peri-orbita, and excision of infiltrated bone in the skull base (clivus). Intraoperative CBCT data was found to dramatically improve surgical performance and confidence in the execution of such tasks. Pre-clinical investigation of this platform in head and neck surgery, as well as spinal, trauma, biopsy, and other nonvascular procedures, is discussed.

Citation Download Citation

J. H. Siewerdsen, Y. Chan M.D., M. A. Rafferty M.D., D. J. Moseley, D. A. Jaffray, and J. C. Irish M.D. "Cone-beam CT with a flat-panel detector on a mobile C-arm: preclinical investigation in image-guided surgery of the head and neck", Proc. SPIE 5744, Medical Imaging 2005: Visualization, Image-Guided Procedures, and Display, (12 April 2005); https://doi.org/10.1117/12.595690

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available