Template-based registration for image-guided skull base surgery

Abstract

To evaluate whether patient-to-image registration with the use of a maxillary template is sufficiently accurate for image guided skull base surgery. In an experimental phantom study, pair-point registration of a skull phantom to its CT image data was performed with 243 different configurations of a maxillary template with markers. Then artificial skull mounted target markers were located with an infrared tracking device as used in navigation systems. The average target registration error was 1.57 mm in the anterior skull base (95% confidence interval, 1.53 to 1.61 mm), but 3.31 mm in the lateral skull base (95% confidence interval, 3.26 to 3.37 mm). Fiducial marker registration based on a maxillary template is sufficiently accurate for image-guided surgery in the anterior skull base, but not for the lateral skull base. Template-based registration is an accurate yet noninvasive registration method for frontal skull base surgery.