Neurosurgical Review

, Volume 34, Issue 2, pp 217–228

Comparative study of application accuracy of two frameless neuronavigation systems: experimental error assessment quantifying registration methods and clinically influencing factors

  • Dimitrios Paraskevopoulos
  • Andreas Unterberg
  • Roland Metzner
  • Jens Dreyhaupt
  • Georg Eggers
  • Christian Rainer Wirtz
Original Article

DOI: 10.1007/s10143-010-0302-5

Cite this article as:
Paraskevopoulos, D., Unterberg, A., Metzner, R. et al. Neurosurg Rev (2011) 34: 217. doi:10.1007/s10143-010-0302-5

Abstract

This study aimed at comparing the accuracy of two commercial neuronavigation systems. Error assessment and quantification of clinical factors and surface registration, often resulting in decreased accuracy, were intended. Active (Stryker Navigation) and passive (VectorVision Sky, BrainLAB) neuronavigation systems were tested with an anthropomorphic phantom with a deformable layer, simulating skin and soft tissue. True coordinates measured by computer numerical control were compared with coordinates on image data and during navigation, to calculate software and system accuracy respectively. Comparison of image and navigation coordinates was used to evaluate navigation accuracy. Both systems achieved an overall accuracy of <1.5 mm. Stryker achieved better software accuracy, whereas BrainLAB better system and navigation accuracy. Factors with conspicuous influence (P < 0.01) were imaging, instrument replacement, sterile cover drape and geometry of instruments. Precision data indicated by the systems did not reflect measured accuracy in general. Surface matching resulted in no improvement of accuracy, confirming former studies. Laser registration showed no differences compared to conventional pointers. Differences between the two systems were limited. Surface registration may improve inaccurate point-based registrations but does not in general affect overall accuracy. Accuracy feedback by the systems does not always match with true target accuracy and requires critical evaluation from the surgeon.

Keywords

Registration Surface matching Neuronavigation Frameless stereotaxy Image-guided surgery Accuracy 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Dimitrios Paraskevopoulos
    • 1
    • 5
  • Andreas Unterberg
    • 1
  • Roland Metzner
    • 2
  • Jens Dreyhaupt
    • 2
  • Georg Eggers
    • 3
  • Christian Rainer Wirtz
    • 1
    • 4
  1. 1.Department of NeurosurgeryUniversity Hospital Heidelberg, Ruprecht-Karls University HeidelbergHeidelbergGermany
  2. 2.Institute for Medical Biometry and InformaticsUniversity Hospital Heidelberg, Ruprecht-Karls University HeidelbergHeidelbergGermany
  3. 3.Department of Maxillofacial SurgeryUniversity Hospital Heidelberg, Ruprecht-Karls University HeidelbergHeidelbergGermany
  4. 4.Department of NeurosurgeryBKH-Günzburg, University UlmUlmGermany
  5. 5.ThessalonikiGreece

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