OBJECTIVE: Accurate image guidance is an essential component of percutaneous procedures in the head and neck. The combination of preprocedural magnetic resonance imaging (MRI) with cone-beam computed tomography (CBCT) and real-time fluoroscopy (the "triple-overlay" technique) could be useful in image-guided targeting of lesions in the head and neck. METHODS: Three patients underwent percutaneous diagnostic or therapeutic procedures of head and neck lesions (mean, 2.3 ± 2.4 cm). One patient presented for biopsy of a small lesion in the infratemporal fossa only visible on MRI, one presented for preoperative embolization of a nasal tumor, and one presented for sclerotherapy of a parotid hemangioma. Preprocedural MRI for each case was merged with CBCT to create a three-dimensional volume for procedural planning. This was then combined with real-time fluoroscopy to create a triple-overlay for needle trajectory and real-time guidance. RESULTS: The registration of MRI, CBCT, and fluoroscopy was successful for all three procedures, allowing 3D manipulation of the combined images. Percutaneous procedures were successful in all patients without complications. CONCLUSIONS: The combination of MRI, CBCT, and real-time fluoroscopy provides detailed anatomical information for 3D image-guided percutaneous procedures of the head and neck, especially for small lesions or lesions with features visible only by MRI.
OBJECTIVE: Accurate image guidance is an essential component of percutaneous procedures in the head and neck. The combination of preprocedural magnetic resonance imaging (MRI) with cone-beam computed tomography (CBCT) and real-time fluoroscopy (the "triple-overlay" technique) could be useful in image-guided targeting of lesions in the head and neck. METHODS: Three patients underwent percutaneous diagnostic or therapeutic procedures of head and neck lesions (mean, 2.3 ± 2.4 cm). One patient presented for biopsy of a small lesion in the infratemporal fossa only visible on MRI, one presented for preoperative embolization of a nasal tumor, and one presented for sclerotherapy of a parotid hemangioma. Preprocedural MRI for each case was merged with CBCT to create a three-dimensional volume for procedural planning. This was then combined with real-time fluoroscopy to create a triple-overlay for needle trajectory and real-time guidance. RESULTS: The registration of MRI, CBCT, and fluoroscopy was successful for all three procedures, allowing 3D manipulation of the combined images. Percutaneous procedures were successful in all patients without complications. CONCLUSIONS: The combination of MRI, CBCT, and real-time fluoroscopy provides detailed anatomical information for 3D image-guided percutaneous procedures of the head and neck, especially for small lesions or lesions with features visible only by MRI.
Authors: Daniel L Cooke; Michael R Levitt; Louis J Kim; Danial K Hallam; Laligam N Sekhar; Basavaraj V Ghodke Journal: Int J Comput Assist Radiol Surg Date: 2015-08-05 Impact factor: 2.924
Authors: Marc C Mabray; Sanjit Datta; Prasheel V Lillaney; Teri Moore; Sonja Gehrisch; Jason F Talbott; Michael R Levitt; Basavaraj V Ghodke; Paul S Larson; Daniel L Cooke Journal: J Neurointerv Surg Date: 2015-06-05 Impact factor: 5.836
Authors: David Dornbos Iii; Cathra Halabi; Julie DiNitto; Kerstin Mueller; David Fiorella; Daniel L Cooke; Adam S Arthur Journal: J Neurointerv Surg Date: 2021-10-11 Impact factor: 8.572