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Smart Stylet: The Development and Use of a Bedside External Ventricular Drain Image-Guidance System

Institution:
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
3Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
4Department of Neurosurgery, Beth Israel Deaconness Medical Center, Boston, MA, USA.
Publisher:
S. Karger AG, Basel, Switzerland
Publication Date:
Feb-2015
Journal:
Stereotact Funct Neurosurg
Volume Number:
93
Issue Number:
1
Pages:
50-8
Citation:
Stereotact Funct Neurosurg. 2015 Feb;93(1):50-8.
PubMed ID:
25662506
PMCID:
PMC4423620
Keywords:
Ventriculostomy, Image-guided surgery, Electromagnetic concepts, Neuronavigation
Appears in Collections:
NCIGT, SLICER
Sponsors:
R42 CA115112/CA/NCI NIH HHS/United States
T15 LM007092/PHS HHS/United States
U41 RR019703/RR/NCRR NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
Generated Citation:
Patil V., Gupta R., San José Estépar R., Lacson R., Cheung A., Wong J.M., Popp A.J., Golby A., Ogilvy C., Vosburgh K.G. Smart Stylet: The Development and Use of a Bedside External Ventricular Drain Image-Guidance System. Stereotact Funct Neurosurg. 2015 Feb;93(1):50-8. PMID: 25662506. PMCID: PMC4423620.
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Background: Placement accuracy of ventriculostomy catheters is reported in a wide and variable range. Development of an efficient image-guidance system may improve physician performance and patient safety. Objective: We evaluate the prototype of Smart Stylet, a new electromagnetic image-guidance system for use during bedside ventriculostomy. Methods: Accuracy of the Smart Stylet system was assessed. System operators were evaluated for their ability to successfully target the ipsilateral frontal horn in a phantom model. Results: Target registration error across 15 intracranial targets ranged from 1.3 to 4.6 mm (mean 3.1 mm). Using Smart Stylet guidance, a test operator successfully passed a ventriculostomy catheter to a shifted ipsilateral frontal horn 20/20 (100%) times from the frontal approach in a skull phantom. Without Smart Stylet guidance, the operator was successful 4/10 (40%) times from the right frontal approach and 6/10 (60%) times from the left frontal approach. In a separate experiment, resident operators were successful 2/4 (50%) times when targeting the shifted ipsilateral frontal horn with Smart Stylet guidance and 0/4 (0%) times without image guidance using a skull phantom. Conclusions: Smart Stylet may improve the ability to successfully target the ventricles during frontal ventriculostomy.

Additional Material
1 File (62.726kB)
Patil-SFN2015-fig3.jpg (62.726kB)