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Intraoperative computed tomography and automated registration for image-guided cranial surgery

G Eggers*,1, B Kress2, S Rohde2 and J Mühling1

1Department of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Germany; 2Department of Neuroradiology, Heidelberg University Hospital, Germany


Figure 1
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  		Figure 1 (a) Surgical position: A, the CT scanner is parked at the wall of the operating room; B, the operating table with C, the transfer board is at sufficient distance to provide enough room for the surgical team. b Imaging position: B, the operating table was moved towards A, the CT scanner; C, the radiolucent transfer board is slid out towards the gantry. The gantry is moved caudally for imaging

 

Figure 2
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  		Figure 2 (a) Attachment of a dynamic reference frame prior to imaging. b A definite geometry of reflective markers serves as dynamic reference frame for the CT gantry

 

Figure 3
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  		Figure 3 Preparation for image data acquisition: A, the infrared tracking camera was adjusted to record the positions of the tracking markers on B, the patient and C, the CT gantry. D, The navigation system is ready to receive the image data for automated registration

 

Figure 4
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  		Figure 4 (a) Attachment of a maxillary splint with marker screws for accuracy measurements. (b) Measurement of target registration error after automated patient-to-image registration: the screenshot shows a triplanar view with axial (top right), coronal (bottom right) and sagittal (bottom left) projection. In each projection, the thin dotted crosshairs indicate the position of a target marker in image data (the centre of the head of a titanium screw). The conical tip (arrow) in the centre of the green crosshairs indicates the position of the same target marker in the patient, measured with the tracked pointer of the navigation system. The target registration error is the Euclidean distance between these two points (in this case 1.7 mm)

 




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