The Relationship of Imaging Techniques to the Accuracy of Frameless Stereotaxy

Publisher: Karger

E-ISSN: 1423-0372|72|2-4|136-141

ISSN: 1011-6125

Source: Stereotactic and Functional Neurosurgery, Vol.72, Iss.2-4, 2000-04, pp. : 136-141

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Abstract

Objective: We analyzed the accuracy of a frameless stereotactic system using computed tomographic (CT) and magnetic resonance imaging (MRI) scans of different slice thickness and T1 versus T2 weighting of MRI. Methods: An open skull with graphite pegs fixed to its base was used for all scans. CT scans were done with slice thicknesses of 1, 2 and 3 mm. MRI-visible markers were placed on top of pegs for T1-weighted and T2-weighted MRI scans, which were acquired at thicknesses of 1.5, 3 and 5 mm. For each scan, 3 separate registrations of a probe were performed; the distance between the actual probe location and that displayed on the registered image was noted. Each measurements was repeated 3 times for each registration. Results: Greatest accuracy was achieved with 3-mm-slice CT scans; this was not improved by using thinner slices. T1-weighted 1.5-mm MRI scans were 23% less accurate and T2-weighted 3-mm scans 37% less accurate. Conclusions: Frameless stereotaxy should be done using CT scans when the greatest possible accuracy is desired. There appears to be no advantage to using slice thicknesses less than 3 mm. For most craniotomy applications, T1-weighted MRI using 3-mm slices provides sufficient accuracy. Lesions imaged only on T2-weighted MRI also can be approached with adequate precision using 3-mm scans.