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Computed Tomography-Current Status
There are several CT systems that have been developed for intraoperative use. The distinguishing feature of most of these systems is portability. A system developed by the Harvard medical school can be wheeled into an elevator or through a doorway and quickly set up in the operating room. The inherent tradeoff with making a system portable is added cost with decreased imaging quality. The Harvard system is able to obtain .8mm resolution, however, which is probably sufficient for most applications. The system is diagrammed at right with resulting images shown below. One significant drawback of this system is that the patient must be rotated 90 degrees onto a x-ray translucent table to be imaged. |
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Phillips Medical Corporation has an intraoperative CT system that is currently being used called the Tomoscan Mmobile. This system consists of a gantry, a CT table, and an operator workstation. In a study performed by Georgetown University, in 6 of 17 spinal neurosurgical cases, CT provided information that altered the course of the surgery. These alterations included more complete tumor resections, ventral decompression of the brainstem, and in one case correcting a slipped transverse process hook. These adaptations could not have been made without the use of intraoperative CT.
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Sources:
http://neurosurgery.mgh.harvard.edu/NeuroScience/mobileCT.htm
http://www.caimr.georgetown.edu/Publications/Posters/intraop%20ct%20in%20or%20poster.pdf
