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23 February 2010 Exploring the clinical validity of predicted TRE in navigation
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In a detailed laboratory investigation we performed a series of experiments in order to assess the validity of the widely used TRE concept to predict the application accuracy. On base of 1mm CT scan a plastic skull, a cadaver head and a volunteer were registered to an in house navigation system. We stored the position data of an optical camera (NDI Polaris) for registration with pre-defined CT coordinates. For every specimen we choose 3, 5, 7 and 9 registration and 10 evaluation points, respectively, performing 10 registrations. The data were evaluated both with the Arun and the Horn approaches. The vectorial difference between actual and predefined position in the CT data set was stored and evaluated for FRE and TRE. Evaluation and visualization was implemented in Matlab. The data were analyzed, specifically for normal distribution, with MS Excel and SPSS Version 15.0. For the plastic skull and the anatomic specimen submillimetric application accuracy was found experimentally and confirmed by the calculated TRE. Since for the volunteer no Titanium screws were implanted anatomic landmarks had to be used for registration and evaluation; an application accuracy in the low millimeter regime was found in all approaches. However, the detailed statistical analysis of the data revealed that the model predictions and the actual measurements do not exhibit a strong statistical correlation (p < 0.05). These data suggest that the TRE predictions are too optimistic and should be used with caution intraoperatively.
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M. Bickel, Ö. Güler, F. Kral, F. Schwarm, and W. Freysinger "Exploring the clinical validity of predicted TRE in navigation", Proc. SPIE 7625, Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling, 762526 (23 February 2010);

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