Brainlab

OBJECTIVE: Fractures of the zygoma and orbit are common facial skeleton injuries. Inadequate reduction and internal fixation may result in functional and aesthetic impairment. The aim of this study was to assess the use of intraoperative 3-dimensional (3-D) cone beam computed tomography (CBCT) for determining the intraoperative revision rate and the need for additional reconstruction of the orbit. STUDY DESIGN: We conducted a retrospective analysis of 48 consecutive patients (15 females, 33 males) suffering from simple or complex zygomatic fractures, seen between June 2015 and October 2016...

BACKGROUND: Voluntary deep inspiration breath hold technique (vDIBH) is considered as the key to achieving the widest cardiac sparing in whole breast irradiation. Several techniques have been implemented to achieve a reproducible, fast and friendly treatment. The aim of the present study is to implement vDIBH using the ExacTrac (BrainLAB AG, Germany) monitoring system. METHODS: Women with left-sided breast cancer, younger than 50 years or with cardiac disease, underwent whole breast RT with vDIBH using the ExacTrac (BrainLAB AG, Germany) monitoring system...

BACKGROUND: The standard freehand method for the insertion of external ventricular drains (EVD) is associated with high rates of incorrect placement. The use of neuronavigation has been shown to reduce the rates of inaccurately positioned EVDs. We present a novel neuronavigation-based approach for EVD placement using flat panel detector computed tomography (FDCT) imaging. METHODS: Four cadaveric heads were used for neuronavigated placement of EVDs using the BrainLAB® reference Headband in combination with laser surface registration and the precalibrated disposable Stylet...

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) becomes increasingly important. For diagnosis and surgery, computed tomography (CT), and cone beam computed tomography (CB-CT) are used equally, although in most of cases, patient positioning differs between supine positioning (CT) and upright seating positioning (CB-CT). We measured volumetric and anatomical changes in the posterior airway space (PAS) between upright and supine positioning in a three-dimensional set up. MATERIALS AND METHODS: Coherent CT and CB-CT scans of 55 patients were included in the study...

Accurate reduction is the key to successful treatment of bone fractures. Complicated zygomaticomaxillary complex fracture, known as one of the most challenging facial bone fractures, is often hard to achieve an accurate reduction, thus leading to facial deformity. In this study, twenty patients with unilateral complicated zygomaticomaxillary complex fractures were included and randomly divided into experimental and control groups, which is with and without the aid of surgical navigation, respectively. The pre- and postoperative imaging data were collected and then analysed using Geomagic Studio 11 software and Brainlab iPlan CMF 3...

AIM: In this study, we clarified changes of the surface dose to a low-density material on a carbon couch and verified whether a novel rigid couch (HM couch) could reduce the surface dose. MATERIALS AND METHODS: We measured the surface dose using only a carbon couch (iBeam Couchtop STANDARD; BrainLab), a low-density material (Styrofoam board) on the carbon couch, and an HM couch for 6 and 10 MV photon beams. RESULTS: A 5-cm styrofoam board placed on the carbon couch reduced the surface dose by approximately 7-9%, while it had no impact on the depth dose profile; however, in use, such a thickness may cause collision of the patient with the gantry head...

Introduction: Stereotactic radiosurgery (SRS) has been increasingly advocated for 1-3 small brain metastases. The goal of this study was to evaluate the clinical results in patients with brain metastases treated with LINAC-based SRS using a thermoplastic mask (non-invasive fixation system) and Image-Guided Radiotherapy (IGRT). Material and Methods: In this single-institution study 48 patients with 77 brain metastases were treated between February 2012 and January 2014...

PURPOSE: The aim of this study was to investigate the intra-fractional patient motion using the ExacTrac system in LINAC-based stereotactic radiosurgery (SRS). METHOD: A retrospective analysis of 104 SRS patients with kilovoltage image-guided setup (Brainlab ExacTrac) data was performed. Each patient was imaged pre-treatment, and at two time points during treatment (1st and 2nd mid-treatment), and bony anatomy of the skull was used to establish setup error at each time point...

PURPOSE: The aim of this study was to develop Quality Assurance procedures for the BrainLab ExacTrac (ET) imaging system following the TG 142 recommendations for planar kV imaging systems. MATERIALS AND METHODS: A custom-designed 3D printed holder was used to position the Standard Imaging QCkV-1 phantom at isocenter, facing the ET X ray tubes. The linac's light field (collimator at 45⁰) was used to position the phantom holder. The ET images were exported to ARIA where geometric distortion was checked...

This paper examines the difference in patient specific dosimetry using three different detectors of varying active volume, density and composition, for quality assurance of stereotactic treatments. A PTW 60017 unshielded electron diode, an Exradin W1 scintillator, and a PTW 31014 PinPoint small volume ionisation chamber were setup in a Lucy 3D QA phantom, and were positioned at the isocentre of an Elekta Axesse, with beam modulator collimator, using Exactrac and a HexaPODTM couch. Dose measurements were acquired for 43 stereotactic arcs, and compared to BrainLAB iPlan version 3...

Stereotactic body radiotherapy (SBRT) for spine tumors has demonstrated clinical effectiveness. The treatment planning and delivery techniques have evolved from dynamic conformal arc therapy, to fixed gantry angle intensity modulated radiotherapy (IMRT), and most recently to volumetric modulated arc therapy (VMAT). A hybrid-arc (HARC) planning and delivery method combining dynamic conformal arc therapy delivery with a number of equally spaced IMRT beams is proposed. In this study we investigated plan quality, delivery accuracy, and efficiency of 3 delivery techniques: IMRT, HARC, and VMAT...

BACKGROUND: A stereotactically placed laser fiber can deliver thermal energy to an epileptogenic focus in the brain. This procedure is done under intraoperative (thermography) magnetic resonance imaging (MRI) guidance. Thermoablation can lead to edema in the surrounding area and can cause a secondary insult. In this report of 3 cases, we have quantified the edema produced after laser ablation by sequential MRI in the immediate postoperative period. CASE DESCRIPTIONS: Three patients with intractable epilepsy underwent a detailed neurologic and neuroradiologic workup to localize the site of epileptogenic foci...

Background: Colloid cysts are rare benign lesions with potentially devastating results. Complications intra and posttreatment can result in high rates of recurrence. Stereotactic radiosurgery may present an attractive option for decreasing the rate of recurrence in conjunction with stereotactic aspiration. Case Description: Here, we report four cases of colloid cyst of the third ventricle managed by stereotactic aspiration with the use of the Leksell frame followed by stereotactic radiosurgery with the BrainLab/Novalis linear accelerator...

Computer-assisted navigation techniques are used to optimise component placement and alignment in total hip replacement. It has developed in the last 10 years but despite its advantages only 0.3% of all total hip replacements in England and Wales are done using computer navigation. One of the reasons for this is that computer-assisted technology increases operative time. A new method of pelvic registration has been developed without the need to register the anterior pelvic plane (BrainLab hip 6.0) which has shown to improve the accuracy of THR...

PURPOSE: The aim of this work is to determine experimentally the correction factors [Formula: see text] for four active commercial dosimeters: two microchambers and two diode detectors based on the output factor measured with radiochromic film for a radiotherapy linear accelerator equipped with circular cones. MATERIALS AND METHODS: Initially, a radiochromic film dosimetry measurement protocol with an accuracy of 2% was developed to approach the "reference output factor"...

BACKGROUND: Intraoperative navigated ultrasonography has reached clinical acceptance, while published data for the accuracy of some systems are missing. We technically quantified and optimised the accuracy of the integration of an external ultrasonography system into a BrainLab navigation system. METHODS: A high-end ultrasonography system (Elegra; Siemens, Erlangen, Germany) was linked to a navigation system (Vector Vision; BrainLab, Munich, Germany). In vitro accuracy and precision was calculated from differences between a real world target (high-precision crosshair phantom) and the ultrasonography image of this target in the navigation coordinate system...

PURPOSE: To evaluate the dosimetric impact of uncorrected rotations on the planning target volume (PTV) coverage for early stage non-small cell lung cancer patients treated with stereotactic body radiotherapy using Brainlab ExacTrac image guidance. METHODS: Twenty-two patients were retrospectively selected. Two scenarios of uncorrected rotations were simulated with magnitude of 1°, 2°, 3° and 5°: (1) rotation around the treatment isocenter; and (2) roll and yaw rotations around a setup isocenter...

OBJECTIVE: Stereotactic procedures are performed in many neurosurgical departments in order to obtain tumor tissue from brain lesions for histopathological evaluation. Biopsies can be performed frame-guided and frame less. Some departments use a biopsy needle (cylinder probe), others a forceps for repetitive smaller tissue samples. Although the applied techniques are somehow different, it is still unclear how many tissue samples have to be taken to establish reliably a final diagnosis based on histopathological and genetic examinations...

BACKGROUND AND IMPORTANCE: Stereotactic biopsies or needle aspirations of posterior fossa lesions are technically challenging. Here we report a novel technique for performing these procedures employing the Airo™ intraoperative computed tomographic (CT) scanner and the VarioGuide™ articulated arm (BrainLab, Munich, Germany). CLINICAL PRESENTATION: A 62-yr-old woman presented with an irregularly shaped, enhancing lesion of the left pons/middle cerebellar peduncle...

BACKGROUND: Electrode placement in epilepsy surgery seeks to locate the sites of ictal onset and early propagation. An invasive diagnostic procedure, stereoelectroencephalography (SEEG) is usually implemented with frame-based methods that can be especially problematic in young children. OBJECTIVE: To evaluate the feasibility and accuracy of a new technique for frameless SEEG in children using the VarioGuide® system (Brainlab AG, München, Germany). METHODS: A frameless stereotactic navigation system was used to implant depth electrodes with percutaneous drilling and bolt insertion in pediatric patients with medically refractory epilepsy...