ACCURACY OF A FRAMELESS OPTICAL STEREOTACTIC NEURONAVIGATION SYSTEM FOR BRAIN BIOPSY IN CATS: A CADAVERIC STUDY

Abstract

Image-guided stereotactic techniques can display the locations of surgical instruments and biopsy targets in real time, allowing minimally invasive brain biopsies with reduced risk. This study aimed to assess the accuracy of an optical frameless neuronavigation system in feline cadavers and describe potential influencing factors. Phantom lesions were created in different brain regions and depths in 15 feline cadavers. After installing eight fiducial markers in the frontal bone and zygomatic arches, magnetic resonance imaging (MRI) was performed, and the images were imported into the neuronavigation system. Following patient and instrument registration, diluted gadolinium was injected into the phantom lesion (target), guided by the neuronavigation system. The coordinates of the target and contrast points were determined on repeated MRI scans and the distance between them was defined as the targeting error. The time from target selection to the completion of gadolinium injection was recorded as the required time. The targeting error and required time were compared between the initial 30% and final 30% of the collected data to assess the influence of operator experience. Among 76 lesions, the mean targeting error was [Formula: see text][Formula: see text]mm (95% confidence interval 2.76–3.15[Formula: see text]mm). Lesion location, lesion depth, and operator experience did not affect the accuracy; however, operator experience reduced the required time. This frameless optical neuronavigation system is potentially feasible for feline brain biopsy. The demonstrated accuracy substantiates its clinical utility for feline brain lesions [Formula: see text][Formula: see text]mm, and is comparable to that of other neuronavigation systems described in dogs.