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1.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(4): 130-136, oct.-dic. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-192959

RESUMO

OBJETIVO: Describir las medidas adoptadas dentro del plan de contingencia del COVID-19 respecto a la biopsia selectiva de ganglio centinela (BSGC) y analizar su impacto sobre la actividad asistencial. METODOLOGÍA: Estudio cualitativo, descriptivo y retrospectivo de BSGC realizadas durante el período del 14/03 al 11/05 de 2020. Análisis de las medidas tomadas para minimizar las probabilidades de contagio y resultados de PCR de pacientes y personal. Comparativa de casos con los realizados en el mismo período de 2019. Actividad diaria de linfogammagrafía y de cirugía radioguiada (CRG) por indicación médica. Cálculo numérico y porcentual de CRG por hospital y recursos humanos diarios de medicina nuclear requeridos. RESULTADOS: Se realizaron 42 intervenciones con BSGC, un 31,1% menos que en 2019. La indicación médica de cáncer de mama experimentó el mayor descenso de actividad (n=18, 41,9%). Del total de CRG, Hospital Clínic realizó el 45,2%, Hospital Maternitat el 31,0%, Hospital Plató el 16,7% y Hospital Sant Joan de Déu el 7,1% restante. En relación con los recursos humanos, la planificación inicial se cumplió en un 77% de los días. El total de los controles PCR a pacientes (n=42) y personal de CRG (n=9) dio resultado negativo. CONCLUSIONES: El COVID-19 influyó negativamente en la actividad asistencial de la BSGC del Hospital Clínic, pero fue compensado por una planificación acertada, basada en el análisis previo de los procesos del procedimiento, que permitió adaptar los recursos de material y personal a las circunstancias cambiantes, otorgándole una flexibilidad que posibilitó el cumplimiento de la programación establecida


OBJECTIVE: To describe the measures taken within the COVID-19 contingency plan concerning sentinel lymph node biopsy (SNB) procedures and to assess their impact on healthcare activity. METHODOLOGY: Qualitative, descriptive and retrospective study of SNB procedures conducted during the lockdown period of COVID-19 (14/03 to 11/05 2020). Analysis of measures taken to minimise the chances of contagion and PCR outcomes of patients and staff. Comparison with SNB procedures conducted in the same time interval in 2019. Daily activity of lymphoscintigraphy and radioguided surgery (RGS) by medical indication. Numerical and percentage calculation of RGS by hospital and daily requirements for human resources in nuclear medicine. RESULTS: Forty-two SNB were performed, representing 31.1% less than those conducted in the same period in 2019. The medical indication of breast cancer showed the greatest activity decrease (n=18, 41.9%). RGS was performed in 45.2% of patients in Hospital Clínic, 31.0% in Maternitat, 16.7% in Plató and 7.1% in Sant Joan de Déu Hospital. Concerning the human resources required, the initial planning was accomplished in 77% of the days (24/31). All the PCR samples from patients (n=42) and RGS staff (n=9) were negative for COVID-19. CONCLUSIONS: COVID-19 negatively influenced the healthcare activity of SNB in Hospital Clínic, but was compensated by adequate planning, based on prior analysis of the procedure's processes, which allowed adaptation of material and personnel resources to the changing circumstances. This allowed flexibility, which in turn enabled compliance with the established schedule


Assuntos
Humanos , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Reação em Cadeia da Polimerase/estatística & dados numéricos , Cirurgia Assistida por Computador/estatística & dados numéricos , Linfocintigrafia/estatística & dados numéricos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Precauções Universais/métodos , Pandemias/estatística & dados numéricos , Biópsia de Linfonodo Sentinela/métodos , Estudos Retrospectivos , Serviço Hospitalar de Medicina Nuclear/estatística & dados numéricos , Gestão da Segurança/métodos
2.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(11): 1376-1381, 2020 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-33191693

RESUMO

Objective: To evaluate the performance, safety, and precision of the Yuanhua robotic-assisted total knee arthroplasty system (YUANHUA-TKA) through animal experiments, which will provide reference data for human clinical trials. Methods: Six 18-month-old goats, weighing 30-35 kg, were used in this study. The experimental study was divided into two parts: the preoperative planning and intraoperative bone resection. CT scans of the goats' lower extremities were firstly performed before the experiments. Then the CT scans were segmented to generate the femoral and tibial three-dimensional (3D) models in the YUANHUA-TKA system. The volumes and angles of each resection plane on the femur and tibia were planned. The bone resection was finally implemented under the assistance of the YUANHUA-TKA system. After completing all bone resections, the lower extremities of each goat were taken to have CT scans. By comparing the femoral and tibial 3D models before and after the experiments, the actual bone resection volumes and angles were calculated and compared with the preoperative values. Results: During the experiments, no abnormal bleeding was found; the YUANHUA-TKA system ran smoothly and stably and was able to stop moving and keep the osteotomy in the safe zone all the time. After the experiment, the resection planes were observed immediately and found to be quite flat. There was no significant difference between the planned and actual osteotomy thickness and osteotomy angle ( P>0.05); the error of the osteotomy thickness was less than 1 mm, and the error of the osteotomy angle was less than 2°. Conclusion: The YUANHUA-TKA system can assist the surgeons to perform osteotomy following the planned thickness and angle values. It is expected to assist surgeons to implement more accurate and efficient osteotomy in the future clinical applications.


Assuntos
Experimentação Animal , Artroplastia do Joelho , Osteoartrite do Joelho , Robótica , Cirurgia Assistida por Computador , Animais , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33151187

RESUMO

Pterygoid implant placement has not been a common treatment modality to manage the atrophic posterior maxilla. This randomized, controlled clinical trial evaluated the accuracy of dynamic navigation using trace registration (TR) technology in pterygoid implant placement when compared to free-hand surgery. Partially edentulous patients requiring at least one pterygoid implant to rehabilitate the atrophic posterior maxilla were included. Implant accuracy (in a prosthetically directed context) and the relation of the placed implants to the greater palatine canal (GPC) were evaluated using EvaluNav to compare the preoperative CBCT plan with the postoperative CBCT implant location. Osseointegration success, mucosal thickness, implant length, time spent for surgical placement, and ease of prosthetic restorability via degree of multi-unit abutment angulation were assessed. A total of 63 pterygoid implants were placed (31 using TR, 32 using free-hand) in 39 partially edentulous patients. Mean deviations between the planned and actual position for TR-placed implants were 0.66 mm at the coronal level, 1.13 mm at the apical level, 0.67 mm in depth, and 2.64 degrees of angular deviation, compared to 1.54 mm, 2.73 mm, 1.17 mm, and 12.49 degrees, respectively, for free-hand implants. In relation to the GPC, TR implants were more accurate when compared to the presurgical plan and took less surgical time. The mean mucosal thickness measured for all implants was 5.41 mm. Most implants were 15 to 18 mm long, and most prostheses (92%) could be accommodated by a 17- or 30-degree multi-unit screw-retained abutment. TR implants had greater short-term osseointegration success rates than free-hand implants (100% vs 93.75%). Pterygoid implant surgery can be a predictable and successful modality for prosthetically directed implant rehabilitation in the atrophic posterior maxilla, is more accurate than free-hand surgery, and takes less time when using dynamic navigation via TR.


Assuntos
Implantes Dentários , Boca Edêntula , Cirurgia Assistida por Computador , Implantação Dentária Endo-Óssea , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 845-850, 2020 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-33171557

RESUMO

Objective: To evalute the accuracy and clinical outcome of a real-time navigation system for the placement of quad zygomatic implants. Methods: Twenty-four patients [9 males and 15 females, mean age was (50.8±14.7) years old], from January 2015 to December 2019, with 96 zygomatic implants placed under a real-time navigation system in Department of Second Dental Center and Department of Oral Implantology of Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were included in the study. The preoperative and the postoperative multislice CT or cone-beam CT were fused to measure and record the entry, exit and angle deviation between the planned and placed implants. The implants were divided into groups according to implant insertion approach (real-time navigation and free-hand), implant length (<47.5 mm and ≥47.5 mm) and implant position (proximal and distal implant). And the differences of implant accuracy were analyzed. The intraoperative and postoperative complications were also recorded. The implant survival rate was evaluated after 6 months follow-up. A P value<0.05 indicates statistical significance. Results: The mean entry, exit and angle deviation of zygomatic implants were (1.49±0.64) mm, [2.03(1.58, 2.40)] mm and (2.49°±1.12°), respectively. The average entry, exit and angle deviation of the navigation guided implant insertion group were (1.45±0.60) mm, (1.96±0.44) mm and (2.66±1.13°) respectively, while those of the free-hand group were (1.50±0.64) mm, (2.04±0.79) mm and (2.50°±1.13°) respectively. There was no significant difference between the two groups (P>0.05). The average entry, exit and angle deviation of the group with length<47.5 mm were (1.42±0.60) mm, (2.13±0.60) mm and (2.61°±1.08°) respectively and those of the group with length ≥ 47.5 mm were (1.52±0.65) mm, (1.98±0.82) mm and (2.43°±1.14°) respectively. No significant difference was found between the two groups (P>0.05). In proximal implant group, the average entry, exit and angle deviation were (1.55±0.69) mm, (2.05±0.92) mm and (2.48°±1.16 °) respectively while those of distal implant group were (1.43±0.57) mm, (2.01±0.57) mm and (2.49°±1.10°), respectively. No significant difference was detected between the two groups (P>0.05). All zygomatic implants were placed uneventfully. There were no intra-operative complications, and post-operative reversible complications developed in 3 patients. Two zygomatic implants were lost and the overall zygomatic implant survival rate was 97.9% (94/96) within a follow-up of 6 months. Conclusions: Quad zygomatic implant placement can be achieved with high accuracy and predictable clinical outcome under guidance of a real-time navigation system.


Assuntos
Implantes Dentários , Arcada Edêntula , Cirurgia Assistida por Computador , Adulto , Idoso , China , Implantação Dentária Endo-Óssea , Feminino , Humanos , Arcada Edêntula/cirurgia , Masculino , Maxila/cirurgia , Pessoa de Meia-Idade , Zigoma/cirurgia
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 864-870, 2020 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-33171560

RESUMO

Objective: To evaluate long-term clinical outcome of implant-supported fixed prosthesis with the guidance of computer-aided design/computer-aided manufacturing (CAD/CAM) surgical template in old patients. Methods: Fifteen 50-67(58.6±5.3) year-old patients (11 males and 4 females) who received the digital implant surgery with the guidance of CAD/CAM surgical template and implant-supported fixed prosthesis in Department of Oral Implantology, Yantai Stomatological Hospital Affiliated to Binzhou Medical College from August, 2013 to Janurary, 2016 were included. There are 15 edentulous maxillas, 8 edentulous mandibles on which 145 implants were placed in total. After the placement of implant, the accuracy of CAD/CAM surgical template was assessed by comparing the post-operative 3-dimensional location of implant with the pre-operative design. The 5-year survival rate of implant and prosthesis was recorded, and marginal bone loss around implants and the development of complication were evaluated by radiological and clinical examination respectively. Results: The result on accuracy of CAD/CAM surgical template showed that deviations in neck and apex of implants were (0.78±0.59) and (1.38±0.63) mm respectively, depth deviation was (0.65±0.35) mm and angle deviation was 4.12°±2.77°. The 5-year cumulative survival rate of implants was 98.6%(143/145). In all 145 implants, the prevalence of implant-related biological complication was 4.1%(6/145). The prosthesis-related mechanical complication rate was 57%(13/23). After 5-year function, mean peri-implant bone loss was (0.69±0.35) mm. Conclusions: This 5-year follow-up retrospective study showed that implant-supported fixed prosthesis with the guidance of CAD/CAM surgical template in middle aged and elderly patients could achieve good long-term clinical outcome and patient satisfaction.


Assuntos
Implantes Dentários , Arcada Edêntula , Cirurgia Assistida por Computador , Idoso , Desenho Assistido por Computador , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Feminino , Humanos , Arcada Edêntula/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 902-907, 2020 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-33171566

RESUMO

Objective: To evaluate the influence of the sleeve lengths and implant lengths on accuracy of static computer-assisted implant surgery (sCAIS). Methods: Twenty-eight models of bilateral mandibular single tooth loss were included. Fifty-five implants were placed under the guidance of sCAIS (Straumann Bone Level 4.1 mm×10 mm). According to the height of metal sleeve of static guide plate, 55 implants were divided into 11 groups (free hand group, 1 mm group, 2 mm group, 3 mm group, 4 mm group, 5 mm group, 6 mm group, 7 mm group, 8 mm group, 9 mm group, 10 mm group), with 5 implants in each group. Eight research models were included. Group with 5 mm sleeve guides were used to place implants of different length, (Straumann Bone Level width 4.1 mm, height was 8 mm, 10 mm and 14 mm), 5 implants in each group. Eighteen patients with mandibular single tooth loss were included in the Department of Oral Implantology, Tianjin Stomatological Hospital from October 2018 to June 2019. There were 10 males and 8 females, 18-46(33.7±7.9) years old. A total of 18 implants were implanted and divided into 3 groups (free hand group, 3 mm group and 5 mm group) with 6 implants in each group. Digital software was used to compare the implant positions before and after implantation. Non-parametric Kruskal-Wallis test or one-way ANOVA were used to analyze the results. Results: There was no significant difference in implant vertical deviation between different sleeve height groups (1-10 mm) and free hand group, but the neck deviation in free hand group[(1.04±0.13) mm] was significantly higher than that in different sleeve height groups (1-10 mm) (P<0.05). The tip deviations of free hand group, 1 mm group and 2 mm group [(1.32±0.43), (0.83±0.10) and (0.78±0.11) mm, respectively] was significantly higher than that of 10 mm group [(0.31±0.14) mm](P<0.05). The angle deviation of free hand group and 1 mm group (3.99°±0.85° and 2.59°±0.69°), respectively] was significantly higher than that of 10 mm group (0.61°±0.03°) (P<0.05). The tip deviations of implants in the 14 mm group [(0.83±0.22) mm] was significantly higher than that in the 8 mm and 10 mm groups [(0.44±0.07) and (0.49±0.06) mm, respectively]. Clinical studies showed that there was no significant difference in neck deviation, tip deviation and angle deviation between 3 mm group and 5 mm group (P>0.05), but deviations were significantly lower than those in free hand group (P<0.05). Conclusions: The length of the sleeves has significant influence on the accuracy of the surgical guide. There was no significant difference in accuracy of the implant guide with 3 mm or 5 mm metal sleeves. The vitro study has some limitations and needs further systematic research.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Perda de Dente , Adolescente , Adulto , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea , Feminino , Humanos , Imageamento Tridimensional , Masculino , Mandíbula/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
7.
Int J Periodontics Restorative Dent ; 40(6): e241-e248, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33151199

RESUMO

Trace registration is a new, alternative registration method for dynamic navigation implant surgery that eliminates the need for an artificial fiducial marker and stent to be present in the CBCT scan, substituting it with other high-contrast landmarks such as teeth, implants, or abutments. Clinical advantages include a streamlined, simplified workflow with fewer opportunities for error; elimination of presurgical steps associated with stent fabrication and imaging; and reduction in radiation risk. Sufficient high-contrast intraoral structures are a prerequisite for using this technique. This case series presents the trace registration protocol and workflow and reports on cases that demonstrate the application of this technology, including postoperative placement accuracy evaluation.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional
9.
Medicine (Baltimore) ; 99(43): e21838, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120726

RESUMO

RATIONALE: The misplaced cervical screw can cause catastrophic surgical complications, such as nerve root damage, vertebral artery compromise, spinal cord injury, and even paraplegia. Thus, the present study aims to describe a novel technique of 3-dimensional printing model (3DPM) combined with 3-dimensional fluoroscopic navigation (3DFN) to facilitate C2 pedicle screw insertion. PATIENT CONCERNS: A 56-year-old male patient presented hypoesthesia of the trunk and extremities, accompanied by a walking disorder. DIAGNOSES: Congenital atlantoaxial malformation with atlantoaxial dislocation. INTERVENTIONS: He underwent an occipital cervical fusion. We used 3DPM and 3DFN technology to guide C2 pedicle screws insertion. OUTCOMES: We inserted 2 pedicle screws and 4 lateral mass screws using the combined 3DPM and 3DFN technology. All screws were classified as excellent position postoperatively. The surgical duration, total fluoroscopic time, and the bleeding volume were 258 minutes, 3.9 minutes, and 237 mL, respectively. No surgical complications, such as neurological compromise, nonunion, dysphagia, infection, polypnea, fixation failure, pseudarthrosis formation, or revision surgery, were observed. The follow-up duration lasted 30 months. LESSONS: The combination of 3DPM and 3DFN to promote C2 pedicle screws implantation is a safe, accurate, reliable, and useful technology, which can achieve an excellent therapeutic effect and avoid surgical complications. However, using the 3DPM and 3DFN technology may increase the financial burden of patients.


Assuntos
Articulação Atlantoaxial/diagnóstico por imagem , Articulação Atlantoaxial/cirurgia , Fluoroscopia , Parafusos Pediculares , Impressão Tridimensional , Fusão Vertebral/métodos , Cirurgia Assistida por Computador , Articulação Atlantoaxial/anormalidades , Perda Sanguínea Cirúrgica , Humanos , Imageamento Tridimensional , Complicações Intraoperatórias/prevenção & controle , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia
10.
Shanghai Kou Qiang Yi Xue ; 29(4): 440-444, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-33089299

RESUMO

PURPOSE: To analyze the accuracy of implant position in simple cases by freehand. METHODS: Ninety-seven implants of 68 patients from 3 surgeons were selected.After operation,the deviations of implant position at shoulder apex and angle were measured using cone-beam CT(CBCT).The mean of three parameters were calculated with SPSS 22.0 software package, and the differences were analyzed between three surgeons,three operation areas,free-end missing and non free-end missing. RESULTS: The deviations of 97 implants were (0.76±0.57)mm,(1.41±0.90)mm,(4.76±3.68)° at shoulder, apex and angle.The deviation of shoulder apex and angle between three surgeons was significantly different(P<0.05). The deviations between left and right group were not significantly different (P>0.05); the deviations between anterior group and left group were significantly different(P<0.05); the deviations between anterior group and right group were not significantly different(P>0.05). The deviation of shoulder between free-end missing area and non free-end missing area was significantly different(P<0.05),other parameters between the two groups were not significantly different(P>0.05). CONCLUSIONS: The deviation of implant placement between surgical guide and mental guide were similar in simple cases. The experience of surgeon was important during freehand implant placement. The deviations were lower when missing tooth is in anterior area than in posterior area, whereas the same at shoulder in non free-end missing area than in free-end missing area.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Algoritmos , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea , Humanos
11.
J Postgrad Med ; 66(4): 215-217, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33109783

RESUMO

Once purely the domain of knee surgery, the use of computer-navigated techniques in total hip arthroplasty (THA) is becoming progressively more commonplace. As with the adoption of any new technology-assisted approach, the uptake of navigated THA utilization has heralded a new suite of technique-specific potential complications. One such example - not usually seen with conventional instrumented THA - pertains to complications related to the insertion and use of fixed pelvic array trackers. This case report describes the unusual circumstance of retained local bony debris generated through application of self-drilling, self-tapping iliac crest pins (for rigid navigation tracker placement) being mis-interpreted on advanced imaging - at a hospital site remote from the index surgery - as an aggressive, early-stage, chondrosarcomatous lesion. This case highlights the critical importance of both a general awareness of common imaging findings after navigated THA surgery (whereby tracker pins have been employed) and the value of 'hands on' clinical assessment of patients to allow correlation with suspicious imaging findings.


Assuntos
Artroplastia de Quadril/efeitos adversos , Pinos Ortopédicos/efeitos adversos , Articulação do Quadril/cirurgia , Pelve/cirurgia , Fraturas Periprotéticas/diagnóstico por imagem , Cirurgia Assistida por Computador/instrumentação , Idoso de 80 Anos ou mais , Artroplastia de Quadril/instrumentação , Feminino , Humanos , Imageamento Tridimensional , Pelve/diagnóstico por imagem , Complicações Pós-Operatórias , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
12.
Zhonghua Yi Xue Za Zhi ; 100(39): 3099-3103, 2020 Oct 27.
Artigo em Chinês | MEDLINE | ID: mdl-33105962

RESUMO

Objective: To investigate the accuracy and clinical efficacy of percutaneous pedicle screw placement under O-arm navigation and traditional fluoroscopy in patients with thoracolumbar fractures without neurological symptoms. Methods: From July 2016 to July 2018, 72 patients with thoracolumbar fractures in Peking University International Hospital without neurological symptoms were divided into two groups, group A and group B. In group A, 36 patients underwent the surgery of percutaneous pedicle screw implantation under traditional fluoroscopy and 168 pedicle screws were inserted. In group B, 36 patients underwent the surgery of percutaneous pedicle screw implantation under O-arm guided fluoroscopy and 164 pedicle screws were inserted by the same surgeon. The general condition, operation condition, radiation dose, fluoroscopy time of single screw, screw placement time and accuracy, visual analogue score (VAS) score, Oswestry dysfunction index (ODI), kyphosis Cobb's angle, anterior edge height of 1 week and 6 months after surgery were compared. The data were compared with paired t test between the two groups. Results: There was no significant differences between the two groups in general condition, intraoperative blood loss, length of hospital stay, VAS, ODI, kyphosis Cobb's angle, and anterior edge height of the injured vertebra (all P>0.05). The operation time was (99±14) min in group A and (75±10) min in group B, the average screw setting time was (15.8±2.6) min in group A and (11.8±3.3) min in group B, the fluoroscopy time of each screw was (38.0±2.0) s in group A and (28.5±2.8) s in group B, the radiation dose of each surgery was (563±163) cGy/cm(2) in group A and (378±70) cGy/cm(2) in group B; the above-mentioned data of group A were all superior to those in group B and the differences between the two groups were all statistically significant (t=8.48, 5.73, 16.30, 6.25, all P<0.05). Rampersaud grading in group A was better than group B, and the differences between the two groups was statistically significant(χ(2)=12.2, P<0.05). Conclusion: The O-arm navigation system could not only provide high-definition navigation images and achieve high-precision navigation operations, which is more accurate than traditional pedicle screws placement, but also contribute to the reconstruction of spinal stability and reduce radiation dose, pedicle screws placement and operating time.


Assuntos
Parafusos Pediculares , Cirurgia Assistida por Computador , Humanos , Imageamento Tridimensional , Vértebras Lombares , Tomografia Computadorizada por Raios X
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5081-5084, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019129

RESUMO

Most image-guided interventions rely on surgical tracking and image/model to patient registration to establish a spatial relationship between the patient and the pre- and intraprocedural images, by using surgical tracking and localization systems. In this work, we characterize the tracking, registration and navigation accuracy using two different surgical localization systems - the NDI Polaris Spectra optical tracking system and the NDI Aurora electromagnetic tracking system - in the context of an image-guided renal intervention, using a 3D printed life-size model of a patient-specific kidney phantom generated from a CT image. Our results reported a 0.05 mm fiducial localization error, 0.70 mm fiducial registration error, and 0.78 mm target registration error, and 0.63 mm overall navigation error using the optical tracking, and 0.12 mm fiducial localization error, 0.78 mm fiducial registration error, 0.93 mm target registration error and 0.89 mm overall navigation error using electromagnetic tracking. Additionally, our study also showed similarity between the overall navigation accuracy using optical (0.63 mm RMS error) or electromagnetic tracking (0.89 mm RMS error) and the overall navigation accuracy achieved using direct visualization of the surgical scene (0.68 mm and 1.06 RMS error respectively), which serves as a baseline control metric.


Assuntos
Cirurgia Assistida por Computador , Fenômenos Eletromagnéticos , Humanos , Imagens de Fantasmas
14.
Am J Orthod Dentofacial Orthop ; 158(5): 674-683, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33008712

RESUMO

INTRODUCTION: This study aimed to assess the accuracy of virtual surgical planning (VSP) performed by Dolphin Imaging software (version 11.9; Dolphin Imaging and Management Solutions, Chatsworth, Calif). METHODS: Ten people requiring bimaxillary surgery and genioplasty were followed up prospectively. All patients had preoperative cone-beam computed tomography, plaster models, and photographs allowing for VSP. Interocclusal intermediate surgical splints were produced using a 3-dimensional (3D) printer. Postoperative images were acquired 15 days after surgery using cone-beam computed tomography. ITK-Snap (version 3.6; Cognitica, Philadelphia, Pa) allowed the segmentation of reliable 3D models. Geomagic Qualify 2013 (3D Systems, Rock Hill, SC) and MeshValmet (version 3.0) were used to identify the differences between VSP and actual surgical results through the root mean square values and the 3D translational displacement (3-axes) of the 3D centroid of each model. RESULTS: Discrepancies between the VSP and the actual result were found at the mandible (P = 0.013) and the chin (P = 0.013) when considering the root mean square values. In addition, 3D centroid differences were found in the transverse and sagittal direction of the right ramus (P = 0.034 and P = 0.005, respectively) and the sagittal aspect of the left ramus (P = 0.025). Considering 2 mm as a threshold of clinical relevance, almost all the bone fragments (maxilla, proximal, and distal mandibular segments) were accurately corrected by surgery, although not in the chin. CONCLUSIONS: On the basis of the obtained values, it is possible to consider the Dolphin Imaging software as clinically acceptable for performing virtual orthognathic surgical planning.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional , Philadelphia
15.
Radiol Clin North Am ; 58(6): 1147-1159, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040854

RESUMO

Neuroendocrine tumors are rare solid tumors with an estimated 12,000 people in the United States diagnosed each year. Neuroendocrine tumors can occur in any part of the body. There is a wide spectrum of disease, ranging from slow-growing and indolent tumors found incidentally to highly aggressive malignancies with a poor prognosis. Knowledge of neuroendocrine tumor pathology is essential in the diagnostic workup of these patients. This article focuses on the evaluation, detection, and staging of common neuroendocrine tumors with multiple imaging modalities; the information gained with a multimodality approach is often complementary and leads to image-guided treatment decision making.


Assuntos
Tomada de Decisão Clínica/métodos , Imagem Multimodal/métodos , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/cirurgia , Cirurgia Assistida por Computador/métodos , Intervalo Livre de Doença , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Tumores Neuroendócrinos/mortalidade , Tumores Neuroendócrinos/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Análise de Sobrevida , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Estados Unidos
16.
Medicine (Baltimore) ; 99(42): e22835, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080763

RESUMO

Even being equipped with advanced surgical navigation systems, thorough analysis of patient's imaging diagnosis before procedures is still of great necessity for the operators. This study aimed to explore the morphological changes of sphenoid sinus lesions as observed on computed tomography (CT), and further carry out the fenestration of sphenoid sinus under guidance of the CT.A retrospective analysis of the characteristics of CT images was performed. The outcomes of three kinds of nasal endoscopic surgeries on benign lesions of sphenoid sinuses were investigated. For the 128 patients included, nasal-cavity-olfactory cleft pathway was performed in 64 patients, the Messerklinger pathway was adopted in 54 patients, while Wigand pathway was performed in the rest 10 patients.After follow-up visit, the drainage at the fenestration site of sphenoid sinus was found to be smooth, the symptoms were completely controlled, and no severe complication was reported during or after the surgery. No significant difference was observed in the curative effects among the 3 groups.CT of the paranasal sinus can guide the procedures of sphenoid sinus fenestration. No statistically significant differences were exhibited in terms of the amount of bleeding, surgical time and days of hospitalization among the 3 groups.


Assuntos
Endoscopia/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/cirurgia , Cirurgia Assistida por Computador , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1169-1173, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018195

RESUMO

The main curative treatment for localized colon cancer is surgical resection. However when tumor residuals are left positive margins are found during the histological examinations and additional treatment is needed to inhibit recurrence. Hyperspectral imaging (HSI) can offer non-invasive surgical guidance with the potential of optimizing the surgical effectiveness. In this paper we investigate the capability of HSI for automated colon cancer detection in six ex-vivo specimens employing a spectral-spatial patch-based classification approach. The results demonstrate the feasibility in assessing the benign and malignant boundaries of the lesion with a sensitivity of 0.88 and specificity of 0.78. The results are compared with the state-of-the-art deep learning based approaches. The method with a new hybrid CNN outperforms the state-of the-art approaches (0.74 vs. 0.82 AUC). This study paves the way for further investigation towards improving surgical outcomes with HSI.


Assuntos
Neoplasias do Colo , Cirurgia Assistida por Computador , Biópsia , Neoplasias do Colo/diagnóstico por imagem , Humanos , Recidiva Local de Neoplasia/diagnóstico por imagem
18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1364-1367, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018242

RESUMO

The anterior pelvic plane (APP) defined by both iliac spines and the pubic symphysis, is essential in total hip arthroplasty (THA) for the orientation of the prosthetic cup. However, the APP is nowadays still difficult to determine in computer assisted orthopedic surgery (CAOS). We propose to use a statistical shape model (SSM) of the pelvis to estimate the APP from ipsilateral anatomical landmarks, more easily accessible during surgery in computer assisted THA with the patient in lateral decubitus position. A SSM of the pelvis has been built from 40 male pelvises. Various ipsilateral anatomical landmarks have been extracted from these data and used to deform the SSM. Fitting the SSM to several combinations of these landmarks, we were able to reconstruct the pelvis with an accuracy between 2.8mm and 4.4mm, and estimate the APP inclination with an angular error between 1.3° and 2.8°, depending on the landmarks fitted. Results are promising and show that the APP could be acquired during the intervention from ipsilateral landmarks only.


Assuntos
Artroplastia de Quadril , Cirurgia Assistida por Computador , Humanos , Masculino , Modelos Estatísticos , Orientação Espacial , Pelve/diagnóstico por imagem
19.
Stomatologiia (Mosk) ; 99(5): 38-45, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034175

RESUMO

THE AIM: To evaluate versality and accuracy of computer navigation in orthognathic surgery, analyzing the position of osteotomized bone fragments on virtual and postoperative 3D models. MATERIAL AND METHODS: During our study we operated 27 patients with different asymmetric deformations of facial skeleton (13 patients with Class III Angle, 11 patients with Class II Angle and 3 patients with hemifacial microsomia). In 7 clinical cases optical navigation stations BrainLab 18070 Kick («BrainLab¼, Germany) and Stryker CranialMap CMF Version 2.0 («Stryker¼, USA) were used for preoperative virtual planning. In other clinical cases (20 patients) preoperative planning performed with using of 3D-cephafolometric programs Dolphin Imagin¼ and Blender 2.79. Intraoperative control of osteotomized bone fragments performed with using of optical navigation stations BrainLab 18070 Kick («BrainLab¼, Germany) and Stryker CranialMap CMF Version 2.0 («Stryker¼, USA). RESULTS: Mean surgical time was 181 minutes (150-210 min). Mean time of registration procedure was 5 minutes (3-8 min). Mean target registration error (TRE) was 0.9±0.18 mm. Absolute difference values between actual and virtual movements of maxilla was from 0.72 to 1.12 mm in vertical, from 0.56 to 0.94 mm in sagittal (COP) and from 0.39 to 0.58 mm in transversal (MSP) planes. CONCLUSION: Intraoperative control of maxilla-mandibular complex with using of computer navigation in orthognathic surgery allows to simplify bone fragments positioning, reduce surgery time, obtain a satisfactory aesthetic treatment result with occlusion restoration.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Humanos , Imageamento Tridimensional , Mandíbula
20.
Orthopade ; 49(10): 893-898, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32909050

RESUMO

The optimal 3D positioning of the prosthesis components is of great importance for the stability and function of a total hip endoprosthesis. Pelvic tilt has a particular influence on the position of the implant. In order to use intraoperatively the knowledge on pelvic kinematics gained through preoperative imaging procedures and movement analyses, "image-based" and "image-free" robotic and navigation procedures are available. With the "image-based" procedures, a 3D CT scan serves as the surgeon's basis for operative planning. The "image-free" procedures are based on the principles of stereotaxy. In the future, information about static and dynamic pelvic tilt will be conntected with navigation and robotic systems for total hip arthroplasty. Along with intraoperative data a patientindividual optimized implant position can be achieved.


Assuntos
Artroplastia de Quadril , Robótica , Cirurgia Assistida por Computador , Acetábulo/cirurgia , Prótese de Quadril , Humanos , Tomografia Computadorizada por Raios X
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