Laser-assisted flat-detector CT-guided intracranial access

PurposeFlat-detector CT can be integrated with C-arm fluoroscopy for CT-guided neurosurgical and endovascular procedures. We studied the accuracy of this technique with laser assistance in targeting intracranial lesions in a cranial model.MethodsAn acrylic scale-model skull containing foam parenchyma was embedded with 2.16-mm-diameter targets. A flat-detector CT was acquired and registered to the skull’s position. Ten targets were accessed with biopsy needles under fluoroscopic guidance, flat-detector CT overlay, and laser assistance. Accuracy was measured from the needle tip to the target center using flat-detector CT.ResultsTen targets were accessed successfully using XperGuide software. Needles were placed within 1.30 $$\pm $$± 0.63 mm of target isocenter. Accuracy did not vary by entry site, operator, location, or lesion depth.ConclusionsLaser-assisted flat-detector CT-guided targeting of all intracranial targets was successful with excellent accuracy. This technique can be applied to other minimally invasive neurosurgical procedures.

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