An Integrated CT-based Image-Guided Neurosurgical System

基于 CT 的集成图像引导神经外科系统

• 批准号: 6886410
• 负责人: JOSEPH Webster STAYMAN
• 金额: $ 14.39万
• 依托单位: XORAN TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6886410
• 关键词: bioimaging /biomedical imaging; biomedical equipment development; brain imaging /visualization /scanning; computed axial tomography; computer system design /evaluation; image enhancement; image guided surgery /therapy; phantom model

DESCRIPTION (provided by applicant): Image-guidance is revolutionizing many medical procedures by providing anatomical information and instrument position during interventions which, in turn, allows for minimally invasive techniques and access to ordinarily inaccessible parts of body. In many difficult procedures that involve vital structures, like the resection of tumors at the skull base, image-guidance can be a necessity. In such cases, the accuracy of the image guidance is often limited by the accuracy of imaging (especially registration). A fully integrated intraoperative image-guidance system combines both the imaging and guidance hardware into a single functioning system that can acquire highly accurate imagery repeatedly within the operating room (OR) environment. Such imagery is well-registered with the true patient coordinates since registration steps are not specifically needed. Moreover, having an intraoperative imager allows one to monitor changes in anatomy throughout a procedure and to assess progress. Such integrated systems have a great advantage over nonintegrated systems where the imagery is collected prior to a procedure followed by registration (i.e.: no updates, more chances for misregistration). Integrated systems based on magnetic resonance imaging are highly attractive due to image quality and lack of ionizing radiation; however, such units place heavy constraints on the OR and are very costly. Units based on ultrasound are inexpensive, but produce relatively poor imagery and are not suitable for regions near bony structures. To date a highly compact, interactive, inexpensive, integrated imaging and guidance system based on x-ray computed tomography (CT) has not been developed. Such a unit would fill a "modality vacancy" in intraoperative imaging and guidance, would provide updatable images familiar to surgeons, and would be particularly suited to difficult procedures like skull base surgery. We propose not only to build such a system (leveraging off previous developments at Xoran Technologies, Inc. for reducing the size of the imager and the effective dosage) but to evaluate the device through clinical trials for the specific task of resection of brain tumors.

描述（由申请人提供）： 图像引导通过在干预期间提供解剖信息和器械位置，正在彻底改变许多医疗程序，从而允许微创技术和进入通常难以接近的身体部位。在许多涉及重要结构的困难手术中，例如颅底肿瘤切除术，图像引导可能是必要的。在这种情况下，图像引导的精度通常受到成像（尤其是配准）精度的限制。完全集成的术中图像引导系统将成像和引导硬件组合成一个功能系统，可以在手术室 (OR) 环境中重复获取高精度图像。由于并不特别需要配准步骤，因此此类图像与真实患者坐标良好配准。此外，拥有术中成像仪可以让人们在整个手术过程中监测解剖结构的变化并评估进展情况。这种集成系统比非集成系统具有很大的优势，非集成系统在注册过程之前收集图像（即：没有更新，注册错误的可能性更大）。基于磁共振成像的集成系统因其图像质量和缺乏电离辐射而极具吸引力；然而，这样的装置对手术室造成了很大的限制，而且成本非常高。基于超声波的装置价格便宜，但产生的图像相对较差，并且不适合骨结构附近的区域。迄今为止，尚未开发出基于 X 射线计算机断层扫描 (CT) 的高度紧凑、交互式、廉价的集成成像和制导系统。这样的装置将填补术中成像和引导中的“模态空缺”，将提供外科医生熟悉的可更新图像，并且特别适合颅底手术等困难手术。我们建议不仅要构建这样一个系统（利用 Xoran Technologies, Inc. 先前的开发成果来减小成像仪的尺寸和有效剂量），还要通过针对脑肿瘤切除特定任务的临床试验来评估该设备。