Despite its broad use in cranial and spinal surgery, navigation support and microscope-based augmented reality (AR) have not yet found their way into posterior fossa surgery in the sitting position. While this position offers surgical benefits, navigation accuracy and thereof the use of navigation itself seems limited. Intraoperative ultrasound (iUS) can be applied at any time during surgery, delivering real-time images that can be used for accuracy verification and navigation updates. Within this study, its applicability in the sitting position was assessed. Data from 15 patients with lesions within the posterior fossa who underwent magnetic resonance imaging (MRI)-based navigation-supported surgery in the sitting position were retrospectively analyzed using the standard reference array and new rigid image-based MRI-iUS co-registration. The navigation accuracy was evaluated based on the spatial overlap of the outlined lesions and the distance between the corresponding landmarks in both data sets, respectively. Image-based co-registration significantly improved (p< 0.001) the spatial overlap of the outlined lesion (0.42 ± 0.30 vs. 0.65 ± 0.23) and significantly reduced (p< 0.001) the distance between the corresponding landmarks (8.69 ± 6.23 mm vs. 3.19 ± 2.73 mm), allowing for the sufficient use of navigation and AR support. Navigated iUS can therefore serve as an easy-to-use tool to enable navigation support for posterior fossa surgery in the sitting position.
尽管导航支持和基于显微镜的增强现实（AR）技术已在颅脑和脊柱手术中广泛应用，但尚未应用于坐位后颅窝手术。虽然坐位具有手术优势，但导航准确性及其应用本身似乎受到限制。术中超声（iUS）可在手术过程中随时使用，提供实时图像，用于准确性验证和导航更新。本研究评估了其在坐位手术中的适用性。通过回顾性分析15例后颅窝病变患者的数据，这些患者在坐位下接受了基于磁共振成像（MRI）的导航支持手术，分别采用标准参考阵列和新型刚性基于图像的MRI-iUS配准方法。导航准确性通过勾画病灶的空间重叠度以及两组数据集中对应解剖标志点之间的距离进行评估。基于图像的配准方法显著提高了勾画病灶的空间重叠度（0.42 ± 0.30 vs. 0.65 ± 0.23，p<0.001），并显著缩小了对应标志点之间的距离（8.69 ± 6.23 mm vs. 3.19 ± 2.73 mm，p<0.001），从而实现了导航和AR支持的充分应用。因此，导航iUS可作为一种简便易用的工具，为坐位后颅窝手术提供导航支持。
肿瘤(癌症)患者之家