The evolving role of neurological imaging in neuro-oncology

Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review

Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.

Three-dimensional Navigation for Thoracoscopic Sublobar Resection Using a Novel Wireless Marking System

We developed a novel localization technique for small intrapulmonary lesions using radiofrequency identification (RFID) technology. Micro-RFID markers with nickel-titanium coils were designed to be placed from subsegmental bronchi to the peripheral parenchyma. In this preclinical study, thoracoscopic subsegmentectomy of a canine pseudotumor model was performed to demonstrate the feasibility and three-dimensional positional accuracy of the system. To recover subcentimeter pseudotumors, markers were bronchoscopically placed to determine the resection line: (1) next to the pseudotumor; (2) in the responsible subsegmental bronchi as the central margin; and (3) on the intersubsegmental plane as the lateral margin. Specific marker positions were located by wireless communication using a wand-shaped probe with a 30-mm communication range, with the distance to the marker indicated by gradual changes in sound pitch. Thirty-four markers were placed for 10 pseudotumors (14.6 mm from the pleura) in 10 canines. Three markers were placed at a mean distance of 5.5 mm from the pseudotumors, and 11 central and 20 lateral markers were placed at mean distances of 17.2 and 20.7 mm from the pseudotumors, respectively. Central markers (20.5 mm from the pleura) were detected within 16.0 seconds in 2.9-mm-diameter bronchi. All resection stumps were within 5.4 mm (range 2-8 mm) from each marker, and pseudotumors were removed with adequate surgical margins toward the central (11.5 mm; range 7-16 mm) and lateral (12.4 mm; range 9-17 mm) directions. RFID wireless markers provided precise three-dimensional positional information and are a potential viable alternative to conventional markers.