An investigation of the potential of rapid prototyping technology for image‐guided surgery

Didier A Rajon,William A Friedman,R Rick Bhasin,Frank J Bova

doi:10.1120/jacmp.v7i4.2302

Didier A Rajon, William A Friedman + Show 2 more

Open Access

https://doi.org/10.1120/jacmp.v7i4.2302

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Abstract

Image‐guided surgery can be broken down into two broad categories: frame‐based guidance and frameless guidance. In order to reduce both the invasive nature of stereotactic guidance and the cost in equipment and time, we have developed a new guidance technique based on rapid prototyping (RP) technology. This new system first builds a computer model of the patient anatomy and then fabricates a physical reference frame that provides a precise and unique fit to the patient anatomy. This frame incorporates a means of guiding the surgeon along a preplanned surgical trajectory. This process involves (1) obtaining a high‐resolution CT or MR scan, (2) building a computer model of the region of interest, (3) developing a surgical plan and physical guide, (4) designing a frame with a unique fit to the patient's anatomy with a physical linkage to the surgical guide, and (5) fabricating the frame using an RP unit. Software was developed to support these processes. To test the accuracy of this process, we first scanned and reproduced a plastic phantom fabricated to validate the system's ability to build an accurate virtual model. A target on the phantom was then identified, a surgical approach planned, a surgical guide designed, and the accuracy and precision of guiding a probe to that target were determined. Steps 1 through 5 were also evaluated using a head phantom. The results show that the RP technology can replicate an object from CT scans with submillimeter resolution. The fabricated reference frames, when positioned on the surface of the phantom and used to guide a surgical probe, can position the probe tip with an accuracy of 1.7 mm at the probe tip. These results demonstrate that the RP technology can be used for the fabrication of customized positioning frames for use in image‐guided surgery.PACS number: 87.57.Gg

Highlights

The ability to map the brain into a set of 3D coordinates is the fundamental basis of stereotactic neurosurgery
The errors shown in the table are the result of the measurement between two surfaces and suggest that the error for each surface is half the error mentioned above. This makes a maximum error of 0.25 mm for the position of a surface. This error is compatible with the accuracy of the rapid prototyping (RP) technology
We investigated the use of RP technology to replicate a tissue-like phantom from a CT scan and to use the image dataset information to fabricate a customized positioning fixture for guiding a biopsy needle to a surgical target

Summary

Introduction

The ability to map the brain into a set of 3D coordinates is the fundamental basis of stereotactic neurosurgery Translating this map into a fixed frame system or a frameless optical system facilitates minimally invasive, accurate, and safe surgery. This technique is used on a daily basis by neurosurgeons to perform brain biopsies, tumor resections, ventricular shunt placements, deep brain stimulator placements, ablative neurosurgery, and spinal instrumentation. To aid the surgeon in appreciating the location of target tissues, computer workstations are used to create 3D models and three-plane views of intracranial anatomy. This allows the surgeon to test and manipulate alternative paths of approach to the target. This type of image-guided surgery falls into two broad categories: frame-based guidance and frameless optical guidance

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