Clinical application of intraoperative 3D x-ray images and development of next generation navigation system

术中3D X线图像的临床应用及下一代导航系统的开发

• 批准号: 22791377
• 负责人: MASAKI Takao
• 金额: $ 2.75万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Young Scientists (B)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 2012
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-22791377/
• 关键词: 3D-fluoroscopy; CT-3D-fluosocopy matching navigation; Orthopaedic surgery; navigation; CT; 股関節鏡視下手術; 経皮的仙腸関節スクリュー固定; flat panel detector; 3DモバイルCアーム; 3Dfluoroscopic navigation; 術中リアルタイム3次元X線画像; 3D fluoroscopic navigation

First, we compared three-dimensional skeletal image quality of a mobile C-arm equipped with a flat panel detector with that of a mobile C-arm equipped with an image intensifier using a dry femoral bone with metal wires．The flat panel detector-equipped C-arm provided higher quality 3D images of a dry femoral bone regardless of presence of metal wires. Second, we developed the new navigation system or the CT -3D-fluoroscopic matching navigation system and applied it to the pelvic and femoral regions. The mean target registration error over the pelvis was 0.8 mm with the imaging center on the ilium. The mean target registration error over the proximal femur was 1.1 mm with the imaging center on the femoral shaft at the level of the lesser trochanter, Third, we performed a surgical simulation study in order to determine whether 3D-fluoroscopic navigation combined with a preoperative CT -based plan could enable surgeons to perform safe and reliable iliosacral screw in sertion. The CT-3D-fluoroscopy matching navigation system reduced the malposition rate of percutaneous iliosacral screw insertion even when performed by less experienced surgeons.Finally, we applied the CT-3D-fluoroscopy matching navigation system for treatment of pelvic ring fractures and arthroscopic treatment. The use of our navigation system was advantageous in terms of less invasiveness, accuracy and safety especially in technical demanding procedures.

首先，我们比较了配备平板探测器的移动 C 形臂和配备使用带有金属线的干股骨的图像增强器的移动 C 形臂的三维骨骼图像质量。无论是否存在金属线，配备平板探测器的 C 形臂都能提供更高质量的干燥股骨 3D 图像。 其次，我们开发了新的导航系统或 CT -3D 荧光镜匹配导航系统，并将其应用于骨盆。成像中心位于髂骨时，骨盆上的平均目标配准误差为 0.8 毫米；成像中心位于股骨近端时，平均目标配准误差为 1.1 毫米。第三，我们进行了一项手术模拟研究，以确定 3D 荧光镜导航与术前基于 CT 的计划相结合是否可以使外科医生在 CT 中进行安全可靠的髂骶螺钉置入。 -3D透视匹配导航系统降低了经皮髂骶螺钉置入的错位率，即使是由经验不足的外科医生进行。最后，我们应用了CT-3D透视匹配导航系统在骨盆环骨折的治疗和关节镜治疗中，使用我们的导航系统在微创性、准确性和安全性方面具有优势，尤其是在技术要求较高的手术中。

项目成果

Accuracy of 3-D Fluoroscopic Navigation System using a Flat Panel Detector-equipped C-arm

使用配备平板探测器的 C 形臂的 3D 透视导航系统的精度

• 发表时间: 2011
• 作者: Takao M; Nishii T; Sakai T; Yabuta K;Yoshikawa H; Sugano N
• 通讯作者: Sugano N

Application of a CT-3D-Fluoroscopy Matching Navigation System to the Pelvic and Femoral Regions

CT-3D透视匹配导航系统在骨盆和股骨区域的应用

• DOI: 10.3109/10929088.2012.654823
• 发表时间: 2012
• 作者: Masaki Takao

A Comparison of 3D Skeletal Images between an Image Intensifier-equipped C-arm and a Flat Panel Detector-equipped C-arm

配备图像增强器的 C 形臂和配备平板探测器的 C 形臂之间的 3D 骨骼图像比较

• 发表时间: 2010
• 作者: Takao M; Nishii T; Sakai T; YoshikawaH; Sugano N
• 通讯作者: Sugano N

パネルディスカッション「新たな低侵襲治療を目指して」CT-3D-Fluoroscopy Matching Navigation System は経験の少ない医師にも経皮的仙腸関節スクリュー固定を容易にする

小组讨论“走向新的微创治疗” CT-3D透视匹配导航系统即使对经验不足的医生也有利于经皮骶髂关节螺钉固定

• 发表时间: 2012
• 作者: 高尾正樹;西井孝;坂井孝司; 菅野伸彦
• 通讯作者: 菅野伸彦

Accuracy Evaluation of CT-3D-Fluoroscopy Matching Navigation System

CT-3D透视匹配导航系统精度评估

• 发表时间: 2011
• 作者: Takao M; Yabuta K; Nishii T; Sakai T;Sugano N
• 通讯作者: Sugano N