title: The impact of the reference imaging modality, registration method and intraoperative flat-panel computed tomography on the accuracy of the ROSA® stereotactic robot.
abstract: OBJECTIVE
  To establish the impact of the imaging modality, registration method and use of intraoperative computed tomography (CT) scan on the accuracy of the ROSA® stereotactic robot.
  
  
  METHODS
  Using a dedicated phantom device, we measured the accuracy of the stereotactic robot for 20 targets as a function of the registration method (frameless, FL, or frame-based, FB) and the reference imaging modality (3T magnetic resonance imaging, MRI, CT scanner or flat-panel CT, fpCT). We performed a retrospective study of the accuracy of the first 26 FB and 31 FL robotized stereotactic surgeries performed in our department.
  
  
  RESULTS
  In a phantom study, the mean target accuracy was 1.59 mm for 3T MRI-guided FL surgery, 0.3 mm for fpCT-guided FL surgery and 0.3 mm for CT-guided FB surgery. In our retrospective series, the mean accuracy was 0.81 mm for FB stereotactic surgery, 1.22 mm for our 24 stereotactic surgery procedures with FL (surface recognition) registration and 0.7 mm for our 7 stereotactic surgery procedures with FL fiducial marker registration. Intraoperative fpCT fully corrected all the registration errors.
  
  
  CONCLUSIONS
  The ROSA stereotactic robot is highly accurate. Robotized FB stereotactic surgery is more accurate than robotized FL stereotactic surgery.
authors.affiliation: Service de Neurochirurgie, CHU Amiens, Amiens, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Lefranc
authors.forename: Cyril
authors.initials: C
authors.lastname: Capel
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Pruvot
authors.forename: Anthony
authors.initials: A
authors.lastname: Fichten
authors.forename: Christine
authors.initials: C
authors.lastname: Desenclos
authors.forename: Patrick
authors.initials: P
authors.lastname: Toussaint
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Gars
authors.forename: Johan
authors.initials: J
authors.lastname: Peltier
mesh_terms: D000328:Adult; D001706:Biopsy / Q000295:instrumentation / Q000379:methods; D002648:Child; D046690:Deep Brain Stimulation / Q000379:methods; D004867:Equipment Design; D057918:Fiducial Markers; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging / Q000592:standards*; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D019047:Phantoms, Imaging; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods; D012015:Reference Standards; D012189:Retrospective Studies; D012371:Robotics; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*