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Technical accuracy of the integration of an external ultrasonography system into a navigation platform: effects of ultrasonography probe registration and target detection

  • Original Article - Brain Tumors
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Abstract

Background

Intraoperative navigated ultrasonography has reached clinical acceptance, while published data for the accuracy of some systems are missing. We technically quantified and optimised the accuracy of the integration of an external ultrasonography system into a BrainLab navigation system.

Methods

A high-end ultrasonography system (Elegra; Siemens, Erlangen, Germany) was linked to a navigation system (Vector Vision; BrainLab, Munich, Germany). In vitro accuracy and precision was calculated from differences between a real world target (high-precision crosshair phantom) and the ultrasonography image of this target in the navigation coordinate system. The influence of the intrinsic component of the calibration phantom (for ultrasonography probe registration), type of target definition (manual versus automatic) and orientation of the ultrasound probe in relation to the navigation tracking device on accuracy and precision were analysed in different settings (100 measurements for each setting) resembling clinically relevant scenarios in the neurosurgical operating theatre.

Results

Line-of-sight angles of 45°, 62° and 90° for the optical tracking of the navigated ultrasonography probe and a distance of 1.8 m revealed best accuracy and precision. Technical accuracy of the integration of ultrasonography into a standard navigation system is high [Euclidean error: median, 0.79 mm; mean, 0.89 ± 0.42 mm for 62° angle; median range: 1.16–1.46 mm; mean range (±SD): 1.22 ± 0.32 mm to 1.46 ± 0.55 mm for grouped analysis of all angles tested]. Software-based automatic target definition improved precision significantly (p < 0.001).

Conclusions

Integration of an external ultrasonography system into the BrainLab navigation is accurate and precise. By modifying registration (and measurement conditions) via software modification, the in vitro accuracy and precision is improved and requirements for a clinical application are fully met.

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Acknowledgments

The data presented in this paper are part of the doctoral thesis of F. A. Wanis.

Funding

This work was supported by a temporary technical support by BrainLab (Test phantom; infra-red camera; modified registration phantom, test-version of the vvCranial 7.81 software). There are no other affiliations or conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Universitätsklinikum Giessen und Marburg GmbH – Standort Giessen, Giessen, Germany

    Frederic A. Wanis, Lars Wessels, Marcus H. T. Reinges, Eberhard Uhl & Andreas Jödicke

  2. Department of Neurosurgery, HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany

    Frederic A. Wanis

  3. Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany

    Lars Wessels

  4. Department of Neurosurgery, Gesundheit Nord gGmbH, Klinikum Bremen-Mitte, St.-Jürgen-Str. 1, 28177, Bremen, Germany

    Marcus H. T. Reinges

  5. Department of Neurosurgery, Vivantes Klinikum Neukölln, Berlin, Germany

    Andreas Jödicke

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  1. Frederic A. Wanis
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Corresponding author

Correspondence to Marcus H. T. Reinges.

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Conflict of interest

Frederic A. Wanis has acted as a Consultant to BrainLab since March 2015.

The other authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1064 Helsinki Declaration and its 403 later amendments or comparable ethical standard.

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Informed consent was obtained from all individual participants included in the study.

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Wanis, F.A., Wessels, L., Reinges, M.H.T. et al. Technical accuracy of the integration of an external ultrasonography system into a navigation platform: effects of ultrasonography probe registration and target detection. Acta Neurochir 160, 305–316 (2018). https://doi.org/10.1007/s00701-017-3416-5

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  • DOI: https://doi.org/10.1007/s00701-017-3416-5

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