Dual-room CT with a sliding gantry for intraoperative imaging: feasibility and workflow analysis of an interdisciplinary concept
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Currently, intraoperative computed tomography (iCT) is a scarcely used technique in neurosurgery. It remains unclear whether this phenomenon is explained by unfavorable iCT-related workflows and/or a limited number of indications. We here analyzed workflows of an installed dual-room iCT (DR-iCT) as compared to surgical procedures lacking iCT. We compared infection rates, utilizations rates, and the spectrum of indications of DR-iCT with that of a previously used single-room iCT.
The study refers to a consecutive series of patients undergoing either single-room iCT (January 2014–August 2014) or DR-iCT (September 2014–July 2016). A further group undergoing surgery without iCT in the interconnected operating rooms represents the reference group. Workflow measurements and infection rates were calculated. Indications for iCT and utilization rates were compared for each of the devices. CT image quality was rated.
Application of DR-iCT led to a broader use of this technique as compared to the single-room device, which concerned in particular stereotactic neurosurgery. Accordingly, iCT utilization rates significantly increased (up to 50.8 ± 4.6 surgeries per month, p < 0.001). Workflow was slightly prolonged in case of DR-iCT imaging; the difference, however, was not statistically significant. Infections rates were low (range 0.0–0.17 infections per month) and not influenced by the utilization rate. Image quality of the DR-iCT was classified as very good in 34/43 evaluated microsurgical patients.
The use of DR-iCT enhances utilization rates with a broader field of indications for intraoperative imaging. Workflow measurements are not significantly prolonged. The technology is safe, and the imaging quality of modern devices can be expected to be good.
KeywordsIntraoperative CT Sliding gantry Dual-room CT scanner Computed tomography
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 5.Schnell O, Morhard D, Holtmannspotter M, Reiser M, Tonn JC, Schichor C (2012) Near-infrared indocyanine green videoangiography (ICGVA) and intraoperative computed tomography (iCT): Are they complementary or competitive imaging techniques in aneurysm surgery? Acta Neurochir 154(10):1861–1868CrossRefPubMedGoogle Scholar
- 12.Terpolilli NA, Rachinger W, Kunz M, Thon N, Flatz WH, Tonn JC, Schichor C (2015) Orbit-associated tumors: navigation and control of resection using intraoperative computed tomography. J Neurosurg 124:1–9Google Scholar
- 16.Kim CS, Maxfield AZ, Foyt D, Rapoport RJ (2017) Utility of intraoperative computed tomography for cochlear implantation in patients with difficult anatomy. Cochlear Implants Int 19:1–10Google Scholar
- 20.Dinevski N, Sarnthein J, Vasella F, Fierstra J, Pangalu A, Holzmann D, Regli L, Bozinov O (2017) Postoperative neurosurgical infection rates after shared-resource intraoperative magnetic resonance imaging—a single center experience with 195 cases. World Neurosurg 103:275–282CrossRefPubMedGoogle Scholar
- 23.Black PM, Moriarty T, Alexander E III, Stieg P, Woodard EJ, Gleason PL, Martin CH, Kikinis R, Schwartz RB, Jolesz FA (1997) Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery 41(4):831–842 (discussion 842–845)CrossRefPubMedGoogle Scholar
- 26.Li P, Qian R, Niu C, Fu X (2016) Impact of intraoperative MRI-guided resection on resection and survival in patient with gliomas: a meta-analysis. Curr Med Res Opin 33:1–28Google Scholar
- 28.Giordano M, Samii A, Lawson McLean AC, Bertalanffy H, Fahlbusch R, Samii M, Di Rocco C (2016) Intraoperative magnetic resonance imaging in pediatric neurosurgery: safety and utility. J Neurosurg Pediatr 19:1–8Google Scholar