Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 35, Issue 7, Pages 959-967Publisher
WILEY
DOI: 10.1002/hed.23060
Keywords
cone-beam CT; image-guided surgery; intraoperative imaging; surgical navigation
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Funding
- Kevin and Sandra Sullivan Chair in Surgical Oncology
- RACH Fund
- Hatch Fund
- National Institutes of Health [R01-CA-127944]
- Siemens Healthcare
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Background Intraoperative 3-dimensional (3D) imaging in head and neck surgery was developed using a prototype mobile C-arm for cone-beam CT (CBCT). This article summarizes its implementation in a prospective pilot and feasibility study. Methods The CBCT C-arm was used in 12 head and neck surgical oncology cases. Human-factors engineering methods and expert feedback from surgeons, nurses, and anesthetists were used to evaluate the impact of intraoperative imaging on the surgical environment and clinical workflow. Image quality of CBCT and the perceived clinical utility were evaluated. Results The CBCT C-arm was successfully incorporated in 12 head and neck cases and streamlined into the surgical environment. Reviewed 3D-CBCT images were qualitatively sufficient for intraoperative-guidance for bony detail. Additional artifact management is required to improve soft-tissue visualization. Conclusions Intraoperative CBCT provides high-quality images for visualization of bony detail and is feasible during major head and neck surgery with acceptable workflow interruptions. Operations with significant bone ablation and/or reconstruction involving complex 3D anatomical structures are likely to benefit from the updated imaging. (c) 2012 Wiley Periodicals, Inc. Head Neck, 2013
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