The accuracy of image-based safety analysis for robotic cochlear implantation.

Rathgeb, Christoph Martin; Wagner, Franca; Wimmer, Wilhelm; Gerber, Nicolas; Williamson, Tom; Anschütz, Lukas Peter; Weder, Stefan; Stadelmann, Marc; Braga, G; Anso, Juan; Caversaccio, Marco; Weber, Stefan; Gerber, Kate (2018). The accuracy of image-based safety analysis for robotic cochlear implantation. (In Press). International Journal of Computer Assisted Radiology and Surgery Springer-Verlag 10.1007/s11548-018-1834-3

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PURPOSE To evaluate the accuracy and reliability of image-based safety analysis for robotic cochlear implantation (RCI) in an ex vivo assessment. METHODS The accuracy was evaluated in a study on 23 human temporal bones. For image analysis, a computer-assisted safety analysis based on intraoperative cone beam computed tomography was implemented. The method automatically segments the drill tunnel and predicts the distance between the tunnel and the facial nerve. In addition, the drilling error at the target is predicted. The predicted distances were compared with the actually drilled distances measured in postoperative high-resolution micro-computed tomography scans. The automatic method was compared to accuracies associated with a manual analysis of the image data. RESULTS The presented computerized image-based analysis enabled the proximity of the facial nerve to the drill trajectory to be predicted with an accuracy of 0.22 ± 0.15 mm and drilling error at the target to be predicted with an accuracy of 0.11 mm ± 0.08 during N = 19 RCI procedures. The manual assessment of facial nerve proximity was performed with an accuracy of 0.34 ± 0.20 mm by a trained clinical expert. CONCLUSION The assessment of intraoperative CT-based imaging presents multiple benefits over alternative safety mechanisms including early detection and applicability even in cases of malformation of the mastoid. This work presents a computer-assisted approach to image analysis that enables procedure safety measurements to be reliably performed with superior accuracy to other proposed safety methodologies, at a safe distance from the facial nerve. Its application must, however, be considered in relation to associated costs (time, cost, irradiation) and the dependence of the measure on a reliable preoperative segmentation.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR)

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Rathgeb, Christoph Martin; Wagner, Franca; Wimmer, Wilhelm; Gerber, Nicolas; Williamson, Tom; Anschütz, Lukas Peter; Weder, Stefan; Stadelmann, Marc; Anso, Juan; Caversaccio, Marco; Weber, Stefan and Gerber, Kate

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1861-6410

Publisher:

Springer-Verlag

Language:

English

Submitter:

Wilhelm Wimmer

Date Deposited:

06 Aug 2018 15:41

Last Modified:

06 Aug 2018 15:41

Publisher DOI:

10.1007/s11548-018-1834-3

PubMed ID:

30073453

Uncontrolled Keywords:

Intraoperative imaging Robotic cochlear implantation Safety mechanism

BORIS DOI:

10.7892/boris.119078

URI:

https://boris.unibe.ch/id/eprint/119078

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