Intraoperative computer tomography imaging

Abstract

Image guided surgery typically relies on preoperatively acquired image data. The major disadvantage is that changes that occur between image data acquisition and surgery, are not reflected by the image data. Furthermore, with the beginning of surgery, the image data is not valid anymore. The use of an intraoperative Computer Tomograhy (CT) suite is reported. The system consists of a single slice spiral CT scanner (Somatom Emotion, Siemens, Forchheim, Germany) and a operating room table with a radiolucent board (AWIGS, Maquet, Rastatt, Germany) to put the patient on. During CT scanning, the patient on the board is immobile, while the gantry of the CT scanner is moved on rails that are embedded in the floor of the operating room. Image data can be transferred immediately via local area network to a frameless stereotaxy system (VectorVision, Brainlab, Heimstetten, Germany). Furthermore, intraoperative image data acquisition in connection with the navigation system can be used for automated patient to image registration. Using the infrared camera of the navigation system, the position of the gantry can be measured during CT image data acquisition. With the patient being tracked simultaneously, registration of the image data can be performed fully automatically. The clinical use of intraoperative CT image data acquisition, the intraoperative workflow of the system, and the clinical applications are demonstrated.