Navigation bone tumorThis research group uses the cone-beam CT scanner to acquire intraoperative 3D scans of difficult orthopedic oncological cases, and operate under navigation guidance.
Aims of this research groupThe overall goal of orthopedic oncological surgery within MITeC is better tumor control and healthy tissue preservation. Standard 2D fluoroscopy provides poor visualization of tumors in complexly shaped bones (such as the pelvis) and the end of long bones. For these cases, we aim to improve tumor control and healthy tissue preservation by operating within MITeC.
We can acquire 3D scans using the intraoperative cone-beam CT, and track the position of surgical instruments within these scans using navigation. Both difficult benign and malignant bone tumor cases may benefit from this technology.
Our first goal was to set up a workflow for benign bone tumor surgery, and assess the feasibility of cone-beam CT navigation for these cases. We have since expanded its application to the more extensive surgery on malignant bone tumors.
Discoveries of this research groupIndications for cone-beam CT navigation for benign bone tumor surgery were:
- closeness to vital structures (e.g. epiphysis, joint cartilage, spinal cord)
- complexly shaped tumors or bone
- minimal invasive surgery
- repeated surgery
Research within MITeCThe MITeC facilities used by our research group are the cone-beam CT scanner and the surgical navigation system. A CT scan is required in order to set up navigation, because CT can be registered to the patient. An MRI with viable information can then be fused with the CT scan in order to be used during navigation. Most of the bone tumor patients however do not have a CT scan available, so one has to be made either preoperatively or intraoperatively. We chose to use the intraoperative cone-beam CT scanner to set up navigation for patients where we expect a health benefit. The scanner is integrated with the MITeC navigation system, so we can start navigation almost immediately.
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