Clinical testing of an alternate method of inserting bone-implanted fiducial markers

Ramya Balachandran; Mark A. Fritz; Mary S. Dietrich; Andrei Danilchenko; Jason E. Mitchell; Veronica L. Oldfield; Wendy W. Lipscomb; J. Michael Fitzpatrick; Joseph S. Neimat; Peter E. Konrad; Robert F. Labadie

doi:10.1007/s11548-014-0980-5

Clinical testing of an alternate method of inserting bone-implanted fiducial markers

Ramya Balachandran, Mark A. Fritz, Mary S. Dietrich, Andrei Danilchenko, Jason E. Mitchell, Veronica L. Oldfield, Wendy W. Lipscomb, J. Michael Fitzpatrick, Joseph S. Neimat, Peter E. Konrad, Robert F. Labadie

Otolaryngology

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Purpose: The purpose of the study was to test clinically a depth-release drive system, the PosiSeat™, versus manual insertion (pilot hole followed by manual screwing until tactile determined correct seating) for implanting fiducial markers into the bone.

Background: Deep brain stimulation (DBS) surgery utilizes image guidance via bone-implanted fiducial markers to achieve the desired submillimetric accuracy and to provide means for attaching microstereotactic frames. For maximal benefit, the markers must be inserted to the correct depth since over-insertion leads to stripping and under-insertion leads to instability.

Methods: With institutional review board approval, the PosiSeat™ was used to implant markers in 15 DBS patients (57 fiducials). On post-insertion CT scans, the depth of the gap between the shoulder of the fiducial markers and the closest bone surface was measured. Similar depth measurements were performed on the CT scans of 64 DBS patients (250 fiducials), who underwent manual fiducial insertion.

Results: Median of shoulder-to-bone distance for PosiSeat™ and manual insertion group were 0.03 and 1.06 mm, respectively. Fifty percent of the fiducials had the shoulder-to-bone distances within 0.01–0.09 mm range for the PosiSeat group and 0.04–1.45 mm range for the manual insertion group. These differences were statistically significant.

Conclusions: A depth-release drive system achieves more consistent placement of bone-implanted fiducial markers than manual insertion.

Original language	English
Pages (from-to)	913-920
Number of pages	8
Journal	International journal of computer assisted radiology and surgery
Volume	9
Issue number	5
DOIs	https://doi.org/10.1007/s11548-014-0980-5
State	Published - Sep 28 2014

Bibliographical note

Publisher Copyright:
© 2014, CARS.

Keywords

Computerized tomography
Deep brain stimulation
Fiducial markers
Image-guided surgery
PosiSeat
Stereotactic surgery

ASJC Scopus subject areas

Surgery
Biomedical Engineering
Radiology Nuclear Medicine and imaging
Computer Vision and Pattern Recognition
Computer Science Applications
Health Informatics
Computer Graphics and Computer-Aided Design

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10.1007/s11548-014-0980-5

Cite this

Balachandran, R., Fritz, M. A., Dietrich, M. S., Danilchenko, A., Mitchell, J. E., Oldfield, V. L., Lipscomb, W. W., Fitzpatrick, J. M., Neimat, J. S., Konrad, P. E., & Labadie, R. F. (2014). Clinical testing of an alternate method of inserting bone-implanted fiducial markers. International journal of computer assisted radiology and surgery, 9(5), 913-920. https://doi.org/10.1007/s11548-014-0980-5

@article{3991b77717bc4eadab006a5b718544f3,

title = "Clinical testing of an alternate method of inserting bone-implanted fiducial markers",

abstract = "Purpose: The purpose of the study was to test clinically a depth-release drive system, the PosiSeat{\texttrademark}, versus manual insertion (pilot hole followed by manual screwing until tactile determined correct seating) for implanting fiducial markers into the bone.Background: Deep brain stimulation (DBS) surgery utilizes image guidance via bone-implanted fiducial markers to achieve the desired submillimetric accuracy and to provide means for attaching microstereotactic frames. For maximal benefit, the markers must be inserted to the correct depth since over-insertion leads to stripping and under-insertion leads to instability.Methods: With institutional review board approval, the PosiSeat{\texttrademark} was used to implant markers in 15 DBS patients (57 fiducials). On post-insertion CT scans, the depth of the gap between the shoulder of the fiducial markers and the closest bone surface was measured. Similar depth measurements were performed on the CT scans of 64 DBS patients (250 fiducials), who underwent manual fiducial insertion.Results: Median of shoulder-to-bone distance for PosiSeat{\texttrademark} and manual insertion group were 0.03 and 1.06 mm, respectively. Fifty percent of the fiducials had the shoulder-to-bone distances within 0.01–0.09 mm range for the PosiSeat group and 0.04–1.45 mm range for the manual insertion group. These differences were statistically significant.Conclusions: A depth-release drive system achieves more consistent placement of bone-implanted fiducial markers than manual insertion.",

keywords = "Computerized tomography, Deep brain stimulation, Fiducial markers, Image-guided surgery, PosiSeat, Stereotactic surgery",

author = "Ramya Balachandran and Fritz, {Mark A.} and Dietrich, {Mary S.} and Andrei Danilchenko and Mitchell, {Jason E.} and Oldfield, {Veronica L.} and Lipscomb, {Wendy W.} and Fitzpatrick, {J. Michael} and Neimat, {Joseph S.} and Konrad, {Peter E.} and Labadie, {Robert F.}",

note = "Publisher Copyright: {\textcopyright} 2014, CARS.",

year = "2014",

month = sep,

day = "28",

doi = "10.1007/s11548-014-0980-5",

language = "English",

volume = "9",

pages = "913--920",

number = "5",

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Balachandran, R, Fritz, MA, Dietrich, MS, Danilchenko, A, Mitchell, JE, Oldfield, VL, Lipscomb, WW, Fitzpatrick, JM, Neimat, JS, Konrad, PE & Labadie, RF 2014, 'Clinical testing of an alternate method of inserting bone-implanted fiducial markers', International journal of computer assisted radiology and surgery, vol. 9, no. 5, pp. 913-920. https://doi.org/10.1007/s11548-014-0980-5

TY - JOUR

T1 - Clinical testing of an alternate method of inserting bone-implanted fiducial markers

AU - Balachandran, Ramya

AU - Fritz, Mark A.

AU - Dietrich, Mary S.

AU - Danilchenko, Andrei

AU - Mitchell, Jason E.

AU - Oldfield, Veronica L.

AU - Lipscomb, Wendy W.

AU - Fitzpatrick, J. Michael

AU - Neimat, Joseph S.

AU - Konrad, Peter E.

AU - Labadie, Robert F.

PY - 2014/9/28

Y1 - 2014/9/28

N2 - Purpose: The purpose of the study was to test clinically a depth-release drive system, the PosiSeat™, versus manual insertion (pilot hole followed by manual screwing until tactile determined correct seating) for implanting fiducial markers into the bone.Background: Deep brain stimulation (DBS) surgery utilizes image guidance via bone-implanted fiducial markers to achieve the desired submillimetric accuracy and to provide means for attaching microstereotactic frames. For maximal benefit, the markers must be inserted to the correct depth since over-insertion leads to stripping and under-insertion leads to instability.Methods: With institutional review board approval, the PosiSeat™ was used to implant markers in 15 DBS patients (57 fiducials). On post-insertion CT scans, the depth of the gap between the shoulder of the fiducial markers and the closest bone surface was measured. Similar depth measurements were performed on the CT scans of 64 DBS patients (250 fiducials), who underwent manual fiducial insertion.Results: Median of shoulder-to-bone distance for PosiSeat™ and manual insertion group were 0.03 and 1.06 mm, respectively. Fifty percent of the fiducials had the shoulder-to-bone distances within 0.01–0.09 mm range for the PosiSeat group and 0.04–1.45 mm range for the manual insertion group. These differences were statistically significant.Conclusions: A depth-release drive system achieves more consistent placement of bone-implanted fiducial markers than manual insertion.

AB - Purpose: The purpose of the study was to test clinically a depth-release drive system, the PosiSeat™, versus manual insertion (pilot hole followed by manual screwing until tactile determined correct seating) for implanting fiducial markers into the bone.Background: Deep brain stimulation (DBS) surgery utilizes image guidance via bone-implanted fiducial markers to achieve the desired submillimetric accuracy and to provide means for attaching microstereotactic frames. For maximal benefit, the markers must be inserted to the correct depth since over-insertion leads to stripping and under-insertion leads to instability.Methods: With institutional review board approval, the PosiSeat™ was used to implant markers in 15 DBS patients (57 fiducials). On post-insertion CT scans, the depth of the gap between the shoulder of the fiducial markers and the closest bone surface was measured. Similar depth measurements were performed on the CT scans of 64 DBS patients (250 fiducials), who underwent manual fiducial insertion.Results: Median of shoulder-to-bone distance for PosiSeat™ and manual insertion group were 0.03 and 1.06 mm, respectively. Fifty percent of the fiducials had the shoulder-to-bone distances within 0.01–0.09 mm range for the PosiSeat group and 0.04–1.45 mm range for the manual insertion group. These differences were statistically significant.Conclusions: A depth-release drive system achieves more consistent placement of bone-implanted fiducial markers than manual insertion.

KW - Computerized tomography

KW - Deep brain stimulation

KW - Fiducial markers

KW - Image-guided surgery

KW - PosiSeat

KW - Stereotactic surgery

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JO - International journal of computer assisted radiology and surgery

JF - International journal of computer assisted radiology and surgery

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Clinical testing of an alternate method of inserting bone-implanted fiducial markers

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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