scholarly journals "Intraoperative Cone Beam CT in Hybrid Operating Room Set-Up as An Alternative to Postoperative CT for Pedicle Screw Breach Detection"

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Mathis Wegner
Keyword(s):  
Pedicle Screw ◽  
Operating Room ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Hybrid Operating Room ◽  
Set Up

Intraoperative cone beam CT in hybrid operating room set-up as an alternative to postoperative CT for pedicle screw breach detection

2021 ◽  
Author(s):  
Simon Peh ◽  
Julian Pfarr ◽  
Jost Philipp Schäfer ◽  
Jan-Hendrik Christensen ◽  
Anindita Chatterjea ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Pedicle Screw ◽  
Operating Room ◽  
Cone Beam Ct ◽  
Pedicle Screws ◽  
Roc Curves ◽  
Cone Beam ◽  
Screw Placement ◽  
Hybrid Operating Room ◽  
Effective Radiation Dose

Abstract Background CT is considered the gold standard for detecting pedicle breach. However, CBCT may be a viable and low radiation dose alternative, to provide intraoperative feedback to surgeons to permit in-room revisions of misplaced screws Methods To assess the ability and reliability of intraoperative cone-beam CT (CBCT) from a robotic C-arm in a hybrid operating room (OR) two hundred forty-one pedicle screws were inserted in cervical, thoracic and lumbar spine of 7 cadavers, followed by CBCT and CT imaging. The CT images served as the standard of reference. Agreement on screw placement between both imaging systems was assessed using Cohen’s Kappa coefficient (κ). Sensitivity, Specificity, Receiver operating characteristic (ROC), area under the empirical and fitted ROC curves (AUC) were computed to assess CBCT as a diagnostic tool compared to CT. The patient effective radiation dose (ED) was calculated for comparison. A systematic literature review was performed to provide perspective to the obtained results. Results Almost perfect agreement in assessing pedicle screw grading between CBCT and CT was observed (κ = 0.84). The sensitivity and specificity of CBCT were 0.84 and 0.98, respectively. The AUC derived from the empirical and fitted ROC curves were 0.95 and 0.96, respectively. Conclusion Intraoperative CBCT by C-arm in a hybrid OR is highly reliable in identification of screw placement at significant dose reduction.

Hybrid Operating Room Cone-Beam CT-Guided PEG-Tube Placement in a Patient with Large Ventral Hernia

2019 ◽  
Vol 85 (7) ◽  
pp. 363-365
Author(s):  
Peter Drevets ◽  
Alyssa Ford ◽  
Stephanie Schampaert ◽  
Carsten Schroeder
Keyword(s):  
Ventral Hernia ◽  
Operating Room ◽  
Cone Beam Ct ◽  
Tube Placement ◽  
Cone Beam ◽  
Hybrid Operating Room ◽  
Ct Guided ◽  
Large Ventral Hernia ◽  
Peg Tube

scholarly journals Clinical efficiency of operating room-based sliding gantry CT as compared to mobile cone-beam CT-based navigated pedicle screw placement in 853 patients and 6733 screws

2021 ◽  
Author(s):  
Sebastian Ille ◽  
Lea Baumgart ◽  
Thomas Obermueller ◽  
Bernhard Meyer ◽  
Sandro M. Krieg
Keyword(s):  
Pedicle Screw ◽  
Operating Room ◽  
Cone Beam Ct ◽  
Spinal Instrumentation ◽  
High Volume ◽  
Cone Beam ◽  
Screw Placement ◽  
Daily Routine ◽  
Pedicle Screw Placement ◽  
Mean Time

Abstract Purpose Multiple solutions for navigation-guided pedicle screw placement are available. However, the efficiency with regard to clinical and resource implications has not yet been analyzed. The present study’s aim was to analyze whether an operating room sliding gantry CT (ORCT)-based approach for spinal instrumentation is more efficient than a mobile cone-beam CT (CBCT)-based approach. Methods This cohort study included a random sample of 853 patients who underwent spinal instrumentation using ORCT-based or CBCT-based pedicle screw placement due to tumor, degenerative, trauma, infection, or deformity disorders between November 2015 and January 2020. Results More screws had to be revised intraoperatively in the CBCT group due to insufficient placement (ORCT: 98, 2.8% vs. CBCT: 128, 4.0%; p = 0.0081). The mean time of patients inside the OR (Interval 5 Entry–Exit) was significantly shorter for the ORCT group (ORCT: mean, [95% CI] 256.0, [247.8, 264.3] min, CBCT: 283.0, [274.4, 291.5] min; p < 0.0001) based on shorter times for Interval 2 Positioning—Incision (ORCT: 18.8, [18.1, 19.9] min, CBCT: 33.6, [32.2, 35.5] min; p < 0.0001) and Interval 4 Suture—Exit (ORCT: 24.3, [23.6, 26.1] min, CBCT: 29.3, [27.5, 30.7] min; p < 0.0001). Conclusions The choice of imaging technology for navigated pedicle screw placement has significant impact on standard spine procedures even in a high-volume spine center with daily routine in such devices. Particularly with regard to the duration of surgeries, the shorter time needed for preparation and de-positioning in the ORCT group made the main difference, while the accuracy was even higher for the ORCT.

scholarly journals Ciliated muconodular papillary tumor with a growing cavity shadow that mimicked colorectal metastasis to the lung: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kotaro Murakami ◽  
Yojiro Yutaka ◽  
Naoki Nakajima ◽  
Akihiko Yoshizawa ◽  
Hiroshi Date
Keyword(s):  
Colorectal Cancer ◽  
Operating Room ◽  
Lung Tumor ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Small Lesion ◽  
Hybrid Operating Room ◽  
Papillary Tumor ◽  
Preoperative Marking ◽  
Dye Marking

Abstract Background Ciliated muconodular papillary tumor (CMPT) is a rare papillary nodule tumor with benign and malignant characteristics that occurs in the peripheral lung. Case presentation A 70-year-old woman who underwent right hemicolectomy for colorectal cancer (CRC; pT3N0M0, p-stage II) 2 years prior, presented with a sub-centimeter growing cavity shadow on chest computed tomography (CT), which was suspected to be a CRC metastasis. Because positron emission tomography CT suggested there was no other site suspicious of recurrence, thoracoscopic resection with preoperative pleural dye marking was planned to remove the small lesion, which seemed to be hardly palpable on CT. Immediately after pleural dye marking adjacent to the lesion using cone beam CT in the hybrid operating room, thoracoscopic wedge resection was performed and the tumor was finally diagnosed as CMPT, characterized by the papillary growth of mucus-producing cells in the alveoli. Conclusion We resected the non-palpable small lung lesions following preoperative marking using cone-beam CT in the hybrid operating room. This case highlights a rare cavitary CT image of a CMPT mimicking a metastatic lung tumor from colorectal cancer.

scholarly journals A Method to Improve Electron Density Measurement of Cone-Beam CT Using Dual Energy Technique

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Kuo Men ◽  
Jian-Rong Dai ◽  
Ming-Hui Li ◽  
Xin-Yuan Chen ◽  
Ke Zhang ◽  
...  
Keyword(s):  
Electron Density ◽  
Cone Beam Ct ◽  
Density Measurement ◽  
Dual Energy ◽  
Cone Beam ◽  
Imaging Method ◽  
Basis Material ◽  
X Ray ◽  
Dual Energy Imaging ◽  
Set Up

Purpose. To develop a dual energy imaging method to improve the accuracy of electron density measurement with a cone-beam CT (CBCT) device.Materials and Methods. The imaging system is the XVI CBCT system on Elekta Synergy linac. Projection data were acquired with the high and low energy X-ray, respectively, to set up a basis material decomposition model. Virtual phantom simulation and phantoms experiments were carried out for quantitative evaluation of the method. Phantoms were also scanned twice with the high and low energy X-ray, respectively. The data were decomposed into projections of the two basis material coefficients according to the model set up earlier. The two sets of decomposed projections were used to reconstruct CBCT images of the basis material coefficients. Then, the images of electron densities were calculated with these CBCT images.Results. The difference between the calculated and theoretical values was within 2% and the correlation coefficient of them was about 1.0. The dual energy imaging method obtained more accurate electron density values and reduced the beam hardening artifacts obviously.Conclusion. A novel dual energy CBCT imaging method to calculate the electron densities was developed. It can acquire more accurate values and provide a platform potentially for dose calculation.

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