A miniature optical neuronavigation system for CT-guided stereotaxy.
OBJECTIVE
Neuronavigation devices have progressed over the past 2 decades, but logistical limitations remain for many stereotactic procedures. We describe our technique and accuracy for a novel miniature optical tracking system which overcomes these limitations.


METHODS
The minioptical tracking system uses a miniature video camera mounted on a rigid cannula to determine cannula location and orientation relative to a patient-attached sticker containing reference markers. A CT scan is used to register these markers to the anatomy and a user-selected target. A computer displays the cannula guidance information to the target. Bench testing was performed on 225 targets in a custom test phantom and additional testing was performed on 20 small targets in an anthropomorphic head phantom to determine the practical accuracy and workflow.


RESULTS
The phantom study demonstrated that 3-D navigation accuracy is 1.41 ± 0.53 mm. There was a 100% head phantom study success rate for the 20 small targets.


CONCLUSIONS
The resulting accuracy data demonstrated good correlation with the CT data, and the clinical simulation workflow indicated its potential usefulness for common neurosurgical applications. Furthermore, this small-footprint tracking technology does not experience the traditional environmentally induced issues or the requirement of pin-based head fixation, allowing for use in the neurointensive care unit and the emergency department.
NeuroTherm, Inc., Wilmington, Mass., USA.
Christopher R
CR
von Jako
Gabor
G
Perlaki
Gergely
G
Orsi
Attila
A
Schwarcz
Tamás
T
Dóczi
D004867:Equipment Design; D006801:Humans; D016343:Monitoring, Intraoperative; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods*; D009493:Neurosurgery / Q000295:instrumentation*; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D013238:Stereotaxic Techniques / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D020535:Video-Assisted Surgery / Q000295:instrumentation / Q000379:methods