Feasibility study of intraoperative cone-beam CT navigation for benign bone tumour surgery

Int J Med Robot. 2019 Jun;15(3):e1993. doi: 10.1002/rcs.1993. Epub 2019 Mar 20.


Background: Intraoperative cone-beam computed tomography (CBCT) offers the advantage of navigation on the current anatomical situation and the possibility to take a control scan. We assessed the feasibility of using intraoperative CBCT for navigated intralesional curettage.

Methods: Nine benign bone tumour patients were studied. Feasibility was assessed by describing the workflow and indications for navigation, scoring CBCT image quality and registration accuracy, and measuring scan and navigation set-up times. Short-term follow-up was described.

Results: CBCT navigation was successful in all patients. Median tumour visibility, tumour delineation, and vital structure visibility scores were good. Median registration accuracy score was very good. Median scan and verification times were 5 and 3 minutes, respectively. One patient had a tumour recurrence after 6 months.

Conclusions: Intraoperative CBCT navigation is feasible and safe. Indications for use of navigation in clinical practice are closeness to vital structures, complexly shaped tumours or bone, minimally invasive surgery, and repeated surgery.

Keywords: bone; computer assisted surgery; cone-beam CT; image guided surgery; intraoperative imaging; navigation; orthopaedic; tumor.

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / surgery
  • Child
  • Cone-Beam Computed Tomography*
  • Equipment Design
  • Feasibility Studies
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Neoplasm Recurrence, Local
  • Preoperative Period
  • Reproducibility of Results
  • Surgery, Computer-Assisted / methods*
  • Young Adult