A new tool for touch-free patient registration for robot-assisted intracranial surgery: application accuracy from a phantom study and a retrospective surgical series

作者：Cardinale Francesco; Rizzi Michele^*; d'Orio Piergiorgio; Casaceli Giuseppe; Arnulfo Gabriele; Narizzano Massimo; Scorza Davide; De Momi Elena; Nichelatti Michele; Redaelli Daniela; Sberna Maurizio; Moscato Alessio; Castana Laura

来源：Neurosurgical Focus, 2017, 42(5): E8.

DOI：10.3171/2017.2.FOCUS16539

• SEEG
• robotics
• Neuromate
• Neurolocate
• frameless
• epilepsy surgery
• depth electrodes
• image-guided surgery

OBJECTIVE The purpose of this study was to compare the accuracy of Neurolocate frameless registration system and frame-based registration for robotic stereoelectroencephalography (SEEG).
METHODS The authors performed a 40-trajectory phantom laboratory study and a 127-trajectory retrospective analysis of a surgical series. The laboratory study was aimed at testing the noninferiority of the Neurolocate system. The analysis of the surgical series compared Neurolocate-based SEEG implantations with a frame-based historical control group.
RESULTS The mean localization errors (LE) +/- standard deviations (SD) for Neurolocate-based and frame-based trajectories were 0.67 +/- 0.29 mm and 0.76 +/- 0.34 mm, respectively, in the phantom study (p = 0.35). The median entry point LE was 0.59 mm (interquartile range [IQR] 0.25-0.88 mm) for Neurolocate-registration-based trajectories and 0.78 mm (IQR 0.49-1.08 mm) for frame-registration-based trajectories (p = 0.00002) in the clinical study. The median target point LE was 1.49 mm (IQR 1.06-2.4 mm) for Neurolocate-registration-based trajectories and 1.77 mm (IQR 1.25-2.5 mm) for frame-registration-based trajectories in the clinical study. All the surgical procedures were successful and uneventful.
CONCLUSIONS The results of the phantom study demonstrate the noninferiority of Neurolocate frameless registration. The results of the retrospective surgical series analysis suggest that Neurolocate-based procedures can be more accurate than the frame-based ones. The safety profile of Neurolocate-based registration should be similar to that of frame-based registration. The Neurolocate system is comfortable, noninvasive, easy to use, and potentially faster than other registration devices.

• 出版日期2017-5