Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors

Gary Nesbit, Eric G. Nesbit, Bronwyn Hamilton

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and aim: Accurate direct puncture access to vascular malformations and tumors of the head and neck is critical to successful embolization treatment and avoidance of complications. The primary focus of this project was to evaluate the accuracy and ease of needle placement using integrated 3D cone-beam CT and fluoroscopic guidance in accessing head and neck vascular malformations and tumors, and to determine its contribution to lesion treatment. Methods: A total of 27 patients, 14 female and 13 male, aged 4-63 years, were included in this study. The lesions included 11 venous malformations, 5 arteriovenous malformations, 5 juvenile nasopharyngeal angiofibromas, 2 lymphovenous malformations, 1 lymphatic malformation, 1 capillary malformation, 1 nasal cavity leiomyoma, and 1 dural arteriovenous fistula. A total of 65 needle placements in 33 procedures were performed using an integrated 3D cone-beam CT and fluoroscopic guidance system. Results: Targeting was successful with a single pass in 62 of 65 planned needle placements to a superficial location in 24, the hypopharynx, retro-pharyngeal, pyriform sinus, or paratracheal spaces in 21, the sphenoid sinus and upper nasal cavity via trans-nasal approach in 5, intra-orbital in 5, intra-laryngeal in 4, pterygo-palatine fossa in 4, external auditory canal in 1, and intracranial via a juxta-torcular burr hole in 1. Needle placement was within 2 mm of the planned target in 11 locations in the 8 patients where post needle-placement cone-beam CT was obtained. Conclusion: This integrated 3D cone-beam CT and fluoroscopic guidance allowed access to deep, difficult to access, locations with ease using a single needle pass in most cases, resulting in improved treatment with decreased procedure times.

Original languageEnglish (US)
Pages (from-to)186-190
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume3
Issue number2
DOIs
StatePublished - Jun 2011

Fingerprint

Vascular Malformations
Cone-Beam Computed Tomography
Needles
Neck
Head
Neoplasms
Nasal Cavity
Therapeutics
Pyriform Sinus
Angiofibroma
Central Nervous System Vascular Malformations
Sphenoid Sinus
Hypopharynx
Ear Canal
Arteriovenous Malformations
Leiomyoma
Nose
Punctures

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors. / Nesbit, Gary; Nesbit, Eric G.; Hamilton, Bronwyn.

In: Journal of NeuroInterventional Surgery, Vol. 3, No. 2, 06.2011, p. 186-190.

Research output: Contribution to journalArticle

@article{116ab3216ffc4d9284a4d06238945a65,
title = "Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors",
abstract = "Background and aim: Accurate direct puncture access to vascular malformations and tumors of the head and neck is critical to successful embolization treatment and avoidance of complications. The primary focus of this project was to evaluate the accuracy and ease of needle placement using integrated 3D cone-beam CT and fluoroscopic guidance in accessing head and neck vascular malformations and tumors, and to determine its contribution to lesion treatment. Methods: A total of 27 patients, 14 female and 13 male, aged 4-63 years, were included in this study. The lesions included 11 venous malformations, 5 arteriovenous malformations, 5 juvenile nasopharyngeal angiofibromas, 2 lymphovenous malformations, 1 lymphatic malformation, 1 capillary malformation, 1 nasal cavity leiomyoma, and 1 dural arteriovenous fistula. A total of 65 needle placements in 33 procedures were performed using an integrated 3D cone-beam CT and fluoroscopic guidance system. Results: Targeting was successful with a single pass in 62 of 65 planned needle placements to a superficial location in 24, the hypopharynx, retro-pharyngeal, pyriform sinus, or paratracheal spaces in 21, the sphenoid sinus and upper nasal cavity via trans-nasal approach in 5, intra-orbital in 5, intra-laryngeal in 4, pterygo-palatine fossa in 4, external auditory canal in 1, and intracranial via a juxta-torcular burr hole in 1. Needle placement was within 2 mm of the planned target in 11 locations in the 8 patients where post needle-placement cone-beam CT was obtained. Conclusion: This integrated 3D cone-beam CT and fluoroscopic guidance allowed access to deep, difficult to access, locations with ease using a single needle pass in most cases, resulting in improved treatment with decreased procedure times.",
author = "Gary Nesbit and Nesbit, {Eric G.} and Bronwyn Hamilton",
year = "2011",
month = "6",
doi = "10.1136/jnis.2010.003376",
language = "English (US)",
volume = "3",
pages = "186--190",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",
number = "2",

}

TY - JOUR

T1 - Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors

AU - Nesbit, Gary

AU - Nesbit, Eric G.

AU - Hamilton, Bronwyn

PY - 2011/6

Y1 - 2011/6

N2 - Background and aim: Accurate direct puncture access to vascular malformations and tumors of the head and neck is critical to successful embolization treatment and avoidance of complications. The primary focus of this project was to evaluate the accuracy and ease of needle placement using integrated 3D cone-beam CT and fluoroscopic guidance in accessing head and neck vascular malformations and tumors, and to determine its contribution to lesion treatment. Methods: A total of 27 patients, 14 female and 13 male, aged 4-63 years, were included in this study. The lesions included 11 venous malformations, 5 arteriovenous malformations, 5 juvenile nasopharyngeal angiofibromas, 2 lymphovenous malformations, 1 lymphatic malformation, 1 capillary malformation, 1 nasal cavity leiomyoma, and 1 dural arteriovenous fistula. A total of 65 needle placements in 33 procedures were performed using an integrated 3D cone-beam CT and fluoroscopic guidance system. Results: Targeting was successful with a single pass in 62 of 65 planned needle placements to a superficial location in 24, the hypopharynx, retro-pharyngeal, pyriform sinus, or paratracheal spaces in 21, the sphenoid sinus and upper nasal cavity via trans-nasal approach in 5, intra-orbital in 5, intra-laryngeal in 4, pterygo-palatine fossa in 4, external auditory canal in 1, and intracranial via a juxta-torcular burr hole in 1. Needle placement was within 2 mm of the planned target in 11 locations in the 8 patients where post needle-placement cone-beam CT was obtained. Conclusion: This integrated 3D cone-beam CT and fluoroscopic guidance allowed access to deep, difficult to access, locations with ease using a single needle pass in most cases, resulting in improved treatment with decreased procedure times.

AB - Background and aim: Accurate direct puncture access to vascular malformations and tumors of the head and neck is critical to successful embolization treatment and avoidance of complications. The primary focus of this project was to evaluate the accuracy and ease of needle placement using integrated 3D cone-beam CT and fluoroscopic guidance in accessing head and neck vascular malformations and tumors, and to determine its contribution to lesion treatment. Methods: A total of 27 patients, 14 female and 13 male, aged 4-63 years, were included in this study. The lesions included 11 venous malformations, 5 arteriovenous malformations, 5 juvenile nasopharyngeal angiofibromas, 2 lymphovenous malformations, 1 lymphatic malformation, 1 capillary malformation, 1 nasal cavity leiomyoma, and 1 dural arteriovenous fistula. A total of 65 needle placements in 33 procedures were performed using an integrated 3D cone-beam CT and fluoroscopic guidance system. Results: Targeting was successful with a single pass in 62 of 65 planned needle placements to a superficial location in 24, the hypopharynx, retro-pharyngeal, pyriform sinus, or paratracheal spaces in 21, the sphenoid sinus and upper nasal cavity via trans-nasal approach in 5, intra-orbital in 5, intra-laryngeal in 4, pterygo-palatine fossa in 4, external auditory canal in 1, and intracranial via a juxta-torcular burr hole in 1. Needle placement was within 2 mm of the planned target in 11 locations in the 8 patients where post needle-placement cone-beam CT was obtained. Conclusion: This integrated 3D cone-beam CT and fluoroscopic guidance allowed access to deep, difficult to access, locations with ease using a single needle pass in most cases, resulting in improved treatment with decreased procedure times.

UR - http://www.scopus.com/inward/record.url?scp=79958071044&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958071044&partnerID=8YFLogxK

U2 - 10.1136/jnis.2010.003376

DO - 10.1136/jnis.2010.003376

M3 - Article

VL - 3

SP - 186

EP - 190

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - 2

ER -