Effect of changing patient position from supine to prone on the accuracy of a brown-roberts-wells stereotactic head frame system

Torsten Rohlfing, Calvin R. Maurer, David Dean, Robert J. Maciunas, Andres M. Lozano, Philip L. Gildenberg, Patrick J. Kelly, Kim Burchiel, Joseph C. Christiano, Ali R. Rezai, Jaimie M. Henderson

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVE: Despite the growing popularity of frameless image-guided surgery systems, stereotactic frame systems are widely accepted by neurosurgeons and are commonly used to perform biopsies, functional procedures, and stereotactic radiosurgery. We investigated the accuracy of the Brown-Roberts-Wells stereotactic frame system when the mechanical load on the frame changes between preoperative imaging and the intervention because of different patient position: supine during imaging, prone during intervention. METHODS: We analyzed computed tomographic images acquired from 14 patients who underwent stereotactic biopsy, deep brain stimulator implantation, or radiosurgery. Two images were acquired for each patient, one with the patient in the supine position and one in the prone position. The prone images were registered to the respective supine images by use of an intensity-based registration algorithm, once using only the frame and once using only the head. The difference between the transformations produced by these two registrations describes the movement of the patient's head with respect to the frame. RESULTS: The maximum frame-based registration error between the supine and prone positions was 2.8 mm; it was more than 2 mm in two patients and more than 1.5 mm in six patients. Anteroposterior translation is the dominant component of the difference transformation for most patients. In general, the magnitude of the movement increased with brain volume, which is an index of head weight. CONCLUSION: To minimize frame-based registration error caused by a change in the mechanical load on the frame, stereotactic procedures should be performed with the patient in the identical position during imaging and intervention.

Original languageEnglish (US)
Pages (from-to)610-618
Number of pages9
JournalNeurosurgery
Volume52
Issue number3
StatePublished - Mar 1 2003
Externally publishedYes

Fingerprint

Supine Position
Head
Prone Position
Radiosurgery
Computer-Assisted Surgery
Biopsy
Head Movements
Brain
Weights and Measures

Keywords

  • Image-guided surgery
  • Mechanical stress
  • Prone position
  • Stereotactic head frame system
  • Stereotactic techniques
  • Stereotactive radiosurgery
  • Stereotaxy
  • Supine position

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Rohlfing, T., Maurer, C. R., Dean, D., Maciunas, R. J., Lozano, A. M., Gildenberg, P. L., ... Henderson, J. M. (2003). Effect of changing patient position from supine to prone on the accuracy of a brown-roberts-wells stereotactic head frame system. Neurosurgery, 52(3), 610-618.

Effect of changing patient position from supine to prone on the accuracy of a brown-roberts-wells stereotactic head frame system. / Rohlfing, Torsten; Maurer, Calvin R.; Dean, David; Maciunas, Robert J.; Lozano, Andres M.; Gildenberg, Philip L.; Kelly, Patrick J.; Burchiel, Kim; Christiano, Joseph C.; Rezai, Ali R.; Henderson, Jaimie M.

In: Neurosurgery, Vol. 52, No. 3, 01.03.2003, p. 610-618.

Research output: Contribution to journalArticle

Rohlfing, T, Maurer, CR, Dean, D, Maciunas, RJ, Lozano, AM, Gildenberg, PL, Kelly, PJ, Burchiel, K, Christiano, JC, Rezai, AR & Henderson, JM 2003, 'Effect of changing patient position from supine to prone on the accuracy of a brown-roberts-wells stereotactic head frame system', Neurosurgery, vol. 52, no. 3, pp. 610-618.
Rohlfing T, Maurer CR, Dean D, Maciunas RJ, Lozano AM, Gildenberg PL et al. Effect of changing patient position from supine to prone on the accuracy of a brown-roberts-wells stereotactic head frame system. Neurosurgery. 2003 Mar 1;52(3):610-618.
Rohlfing, Torsten ; Maurer, Calvin R. ; Dean, David ; Maciunas, Robert J. ; Lozano, Andres M. ; Gildenberg, Philip L. ; Kelly, Patrick J. ; Burchiel, Kim ; Christiano, Joseph C. ; Rezai, Ali R. ; Henderson, Jaimie M. / Effect of changing patient position from supine to prone on the accuracy of a brown-roberts-wells stereotactic head frame system. In: Neurosurgery. 2003 ; Vol. 52, No. 3. pp. 610-618.
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abstract = "OBJECTIVE: Despite the growing popularity of frameless image-guided surgery systems, stereotactic frame systems are widely accepted by neurosurgeons and are commonly used to perform biopsies, functional procedures, and stereotactic radiosurgery. We investigated the accuracy of the Brown-Roberts-Wells stereotactic frame system when the mechanical load on the frame changes between preoperative imaging and the intervention because of different patient position: supine during imaging, prone during intervention. METHODS: We analyzed computed tomographic images acquired from 14 patients who underwent stereotactic biopsy, deep brain stimulator implantation, or radiosurgery. Two images were acquired for each patient, one with the patient in the supine position and one in the prone position. The prone images were registered to the respective supine images by use of an intensity-based registration algorithm, once using only the frame and once using only the head. The difference between the transformations produced by these two registrations describes the movement of the patient's head with respect to the frame. RESULTS: The maximum frame-based registration error between the supine and prone positions was 2.8 mm; it was more than 2 mm in two patients and more than 1.5 mm in six patients. Anteroposterior translation is the dominant component of the difference transformation for most patients. In general, the magnitude of the movement increased with brain volume, which is an index of head weight. CONCLUSION: To minimize frame-based registration error caused by a change in the mechanical load on the frame, stereotactic procedures should be performed with the patient in the identical position during imaging and intervention.",
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AU - Maurer, Calvin R.

AU - Dean, David

AU - Maciunas, Robert J.

AU - Lozano, Andres M.

AU - Gildenberg, Philip L.

AU - Kelly, Patrick J.

AU - Burchiel, Kim

AU - Christiano, Joseph C.

AU - Rezai, Ali R.

AU - Henderson, Jaimie M.

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N2 - OBJECTIVE: Despite the growing popularity of frameless image-guided surgery systems, stereotactic frame systems are widely accepted by neurosurgeons and are commonly used to perform biopsies, functional procedures, and stereotactic radiosurgery. We investigated the accuracy of the Brown-Roberts-Wells stereotactic frame system when the mechanical load on the frame changes between preoperative imaging and the intervention because of different patient position: supine during imaging, prone during intervention. METHODS: We analyzed computed tomographic images acquired from 14 patients who underwent stereotactic biopsy, deep brain stimulator implantation, or radiosurgery. Two images were acquired for each patient, one with the patient in the supine position and one in the prone position. The prone images were registered to the respective supine images by use of an intensity-based registration algorithm, once using only the frame and once using only the head. The difference between the transformations produced by these two registrations describes the movement of the patient's head with respect to the frame. RESULTS: The maximum frame-based registration error between the supine and prone positions was 2.8 mm; it was more than 2 mm in two patients and more than 1.5 mm in six patients. Anteroposterior translation is the dominant component of the difference transformation for most patients. In general, the magnitude of the movement increased with brain volume, which is an index of head weight. CONCLUSION: To minimize frame-based registration error caused by a change in the mechanical load on the frame, stereotactic procedures should be performed with the patient in the identical position during imaging and intervention.

AB - OBJECTIVE: Despite the growing popularity of frameless image-guided surgery systems, stereotactic frame systems are widely accepted by neurosurgeons and are commonly used to perform biopsies, functional procedures, and stereotactic radiosurgery. We investigated the accuracy of the Brown-Roberts-Wells stereotactic frame system when the mechanical load on the frame changes between preoperative imaging and the intervention because of different patient position: supine during imaging, prone during intervention. METHODS: We analyzed computed tomographic images acquired from 14 patients who underwent stereotactic biopsy, deep brain stimulator implantation, or radiosurgery. Two images were acquired for each patient, one with the patient in the supine position and one in the prone position. The prone images were registered to the respective supine images by use of an intensity-based registration algorithm, once using only the frame and once using only the head. The difference between the transformations produced by these two registrations describes the movement of the patient's head with respect to the frame. RESULTS: The maximum frame-based registration error between the supine and prone positions was 2.8 mm; it was more than 2 mm in two patients and more than 1.5 mm in six patients. Anteroposterior translation is the dominant component of the difference transformation for most patients. In general, the magnitude of the movement increased with brain volume, which is an index of head weight. CONCLUSION: To minimize frame-based registration error caused by a change in the mechanical load on the frame, stereotactic procedures should be performed with the patient in the identical position during imaging and intervention.

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KW - Stereotactive radiosurgery

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KW - Supine position

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