Adam Hopfgartner1, David Burns1,2,3, Suganth Suppiah4, Allan R Martin5, Michael Hardisty1,2, Cari M Whyne6,7,8. 1. Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, ON, Canada. 2. Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada. 3. Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada. 4. Division of Neurosurgery, University of Toronto, Toronto, ON, Canada. 5. Department of Neurological Surgery, University of California, Davis, Sacramento, CA, USA. 6. Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, ON, Canada. cari.whyne@sunnybrook.ca. 7. Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada. cari.whyne@sunnybrook.ca. 8. Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada. cari.whyne@sunnybrook.ca.
Abstract
PURPOSE: External ventricular drainage (EVD) is a life-saving procedure indicated for elevated intracranial pressure. A catheter is inserted into the ventricles to drain cerebrospinal fluid and release the pressure on the brain. However, the standard freehand EVD technique results in catheter malpositioning in up to 60.1% of procedures. This proof-of-concept study aimed to evaluate the registration accuracy of a novel image-based verification system "Bullseye EVD" in a preclinical cadaveric model of catheter placement. METHODS: Experimentation was performed on both sides of 3 cadaveric heads (n = 6). After a pre-interventional CT scan, a guidewire simulating the EVD catheter was inserted as in a clinical EVD procedure. 3D structured light images (Einscan, Shining 3D, China) were acquired of an optical tracker placed over the guidewire on the surface of the scalp, along with three distinct cranial regions (scalp, face, and ear). A computer vision algorithm was employed to determine the guidewire position based on the pre-interventional CT scan and the intra-procedural optical imaging. A post-interventional CT scan was used to validate the performance of the Bullseye optical imaging system in terms of trajectory and offset errors. RESULTS: Optical images which combined facial features and exposed scalp within the surgical field resulted in the lowest trajectory and offset errors of 1.28° ± 0.38° and 0.33 ± 0.19 mm, respectively. Mean duration of the optical imaging procedure was 128 ± 35 s. CONCLUSIONS: The Bullseye EVD system presents an accurate patient-specific method to verify freehand EVD positioning. Use of facial features was critical to registration accuracy. Workflow automation and development of a user interface must be considered for future clinical evaluation.
PURPOSE: External ventricular drainage (EVD) is a life-saving procedure indicated for elevated intracranial pressure. A catheter is inserted into the ventricles to drain cerebrospinal fluid and release the pressure on the brain. However, the standard freehand EVD technique results in catheter malpositioning in up to 60.1% of procedures. This proof-of-concept study aimed to evaluate the registration accuracy of a novel image-based verification system "Bullseye EVD" in a preclinical cadaveric model of catheter placement. METHODS: Experimentation was performed on both sides of 3 cadaveric heads (n = 6). After a pre-interventional CT scan, a guidewire simulating the EVD catheter was inserted as in a clinical EVD procedure. 3D structured light images (Einscan, Shining 3D, China) were acquired of an optical tracker placed over the guidewire on the surface of the scalp, along with three distinct cranial regions (scalp, face, and ear). A computer vision algorithm was employed to determine the guidewire position based on the pre-interventional CT scan and the intra-procedural optical imaging. A post-interventional CT scan was used to validate the performance of the Bullseye optical imaging system in terms of trajectory and offset errors. RESULTS: Optical images which combined facial features and exposed scalp within the surgical field resulted in the lowest trajectory and offset errors of 1.28° ± 0.38° and 0.33 ± 0.19 mm, respectively. Mean duration of the optical imaging procedure was 128 ± 35 s. CONCLUSIONS: The Bullseye EVD system presents an accurate patient-specific method to verify freehand EVD positioning. Use of facial features was critical to registration accuracy. Workflow automation and development of a user interface must be considered for future clinical evaluation.
Authors: David R Huyette; Benjamin J Turnbow; Christian Kaufman; Dale F Vaslow; Benjamin B Whiting; Michael Y Oh Journal: J Neurosurg Date: 2008-01 Impact factor: 5.115
Authors: Eliza H Hersh; Kurt A Yaeger; Sean N Neifert; Julie Kim; Neha S Dangayach; Nirit Weiss Journal: World Neurosurg Date: 2019-03-28 Impact factor: 2.104
Authors: Yaseen Arabi; Ziad A Memish; Hanan H Balkhy; Christine Francis; Ahmad Ferayan; Abdullah Al Shimemeri; Maha A Almuneef Journal: Am J Infect Control Date: 2005-04 Impact factor: 2.918
Authors: Cheng H Lo; Denis Spelman; Michael Bailey; D James Cooper; Jeffrey V Rosenfeld; John E Brecknell Journal: J Neurosurg Date: 2007-03 Impact factor: 5.115