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Journal of veterinary internal medicine2020; 34(4); 1642-1649; doi: 10.1111/jvim.15813

A pilot study of optical neuronavigation-guided brain biopsy in the horse using anatomic landmarks and fiducial arrays for patient registration.

Abstract: Optical neuronavigation-guided intracranial surgery has become increasingly common in veterinary medicine, but its use has not yet been described in horses. Objective: To determine the feasibility of optical neuronavigation-guided intracranial biopsy procedures in the horse, compare the use of the standard fiducial array and anatomic landmarks for patient registration, and evaluate surgeon experience. Methods: Six equine cadaver heads. Methods: Computed tomography images of each specimen were acquired, with the fiducial array rigidly secured to the frontal bone. Six targets were selected in each specimen. Patient registration was performed separately for 3 targets using the fiducial array, and for 3 targets using anatomic landmarks. In lieu of biopsy, 1 mm diameter wire seeds were placed at each target. Postoperative images were coregistered with the planning scan to calculate Euclidian distance from the tip of the seed to the target. Results: No statistical difference between registration techniques was identified. The impact of surgeon experience was examined for each technique using a Mann-Whitney U test. The experienced surgeon was significantly closer to the intended target (median = 2.52 mm) than were the novice surgeons (median = 6.55 mm) using the fiducial array (P = .001). Although not statistically significant (P = .31), for the experienced surgeon the median distance to target was similar when registering with the fiducial array (2.47 mm) and anatomic landmarks (2.58 mm). Conclusions: Registration using both fiducial arrays and anatomic landmarks for brain biopsy using optical neuronavigation in horses is feasible.
Publication Date: 2020-05-29 PubMed ID: 32469442PubMed Central: PMC7379038DOI: 10.1111/jvim.15813Google Scholar: Lookup
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  • Journal Article

Summary

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This research article presents a pilot study that aims to determine the feasibility of using optical neuronavigation-guided intracranial biopsy procedures in horses. It also explores and compares the use of fiducial arrays and anatomical landmarks for patient registration. The study also investigates the impact of surgeon experience on its efficiency.

Concepts and Methods

The research involved six equine (horse) cadaver heads as models for the study, due to the unavailability of live subjects. Key concepts in the method include:

  • Computed Tomography (CT): CT images of each specimen were acquired before the procedure. This provided the necessary anatomical information to conduct the neuronavigation.
  • Fiducial Array: A fiducial array is a set of specific points used in image analysis to determine spatial transformation. The fiducial array was secured to the frontal bone of the specimen heads.
  • Anatomic Landmarks: Anatomic landmarks were also used for patient registration, marking another method for aligning the physical specimen with its image representation.
  • Biopsy Surrogate: Instead of performing an actual biopsy, the researchers placed wire seeds with a diameter of 1mm at each target. This served as a proxy for examining the precision of the biopsy procedure.

Comparison of Registration Techniques and Surgeon Experience

The accuracy of placing the wire seeds was analyzed by calculating the Euclidean distance from the tip of the seed to the target, revealing the effectiveness of each registration technique. Key findings include:

  • Neither fiducial array nor anatomic landmarks registration showed a notable statistical difference, suggesting both are valid methods for this type of operation.
  • The impact of surgeon experience was examined, showing that an experienced surgeon was significantly closer to the intended target than novice surgeons. This underscores the role of professional expertise in medical surgery procedures.

Conclusion

In conclusion, the study found that optical neuronavigation-guided intracranial biopsy procedures in horses are feasible, and both fiducial arrays and anatomic landmarks can be used for patient registration. The efficiency of the procedure is significantly affected by the surgeon’s experience.

Cite This Article

APA
Santistevan L, Easley J, Ruple A, Monck S, Randall E, Wininger F, Packer RA. (2020). A pilot study of optical neuronavigation-guided brain biopsy in the horse using anatomic landmarks and fiducial arrays for patient registration. J Vet Intern Med, 34(4), 1642-1649. https://doi.org/10.1111/jvim.15813

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 34
Issue: 4
Pages: 1642-1649

Researcher Affiliations

Santistevan, Lawrence
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Easley, Jeremiah
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Ruple, Audrey
  • Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA.
Monck, Sam
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Randall, Elissa
  • Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Wininger, Fred
  • Charlotte Animal Referral and Emergency, Charlotte, North Carolina, USA.
Packer, Rebecca A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Anatomic Landmarks
  • Animals
  • Biopsy / methods
  • Biopsy / veterinary
  • Brain / surgery
  • Horses / surgery
  • Neuronavigation / instrumentation
  • Neuronavigation / methods
  • Neuronavigation / veterinary
  • Pilot Projects

Grant Funding

  • Preclinical Surgical Research Laboratory, Colorado State University
  • Young Investigator Grant Program, Center for Companion Animal Studies, Colorado State University

Conflict of Interest Statement

Authors declare no conflict of interest.

References

This article includes 35 references
  1. Chen AV, Wininger FA, Frey S, Comeau RM, Bagley RS, Tucker RL, Schneider AR, Gay JM. Description and validation of a magnetic resonance imaging-guided stereotactic brain biopsy device in the dog.. Vet Radiol Ultrasound 2012 Mar-Apr;53(2):150-6.
  2. Packer RA, McGrath S. Onscreen-guided resection of extra-axial and intra-axial forebrain masses through registration of a variable-suction tissue resection device with a neuronavigation system.. Vet Surg 2020 May;49(4):676-684.
    pubmed: 32220078doi: 10.1111/vsu.13414google scholar: lookup
  3. Taylor AR, Cohen ND, Fletcher S, Griffin JF, Levine JM. Application and machine accuracy of a new frameless computed tomography-guided stereotactic brain biopsy system in dogs.. Vet Radiol Ultrasound 2013 Jul-Aug;54(4):332-342.
    pubmed: 23551960doi: 10.1111/vru.12025google scholar: lookup
  4. Long S, Frey S, Freestone DR, LeChevoir M, Stypulkowski P, Giftakis J, Cook M. Placement of deep brain electrodes in the dog using the Brainsight frameless stereotactic system: a pilot feasibility study.. J Vet Intern Med 2014 Jan-Feb;28(1):189-97.
    pmc: PMC4895539pubmed: 24237394doi: 10.1111/jvim.12235google scholar: lookup
  5. Packer RA, Freeman LJ, Miller MA, Fauber AE, Morrison WB. Evaluation of minimally invasive excisional brain biopsy and intracranial brachytherapy catheter placement in dogs.. Am J Vet Res 2011 Jan;72(1):109-21.
    pubmed: 21194343doi: 10.2460/ajvr.72.1.109google scholar: lookup
  6. Moissonnier P, Bordeau W, Delisle F, Devauchelle P. Accuracy testing of a new stereotactic CT -guided brain biopsy device in the dog.. Res Vet Sci 2000 Jun;68(3):243-7.
    pubmed: 10877970doi: 10.1053/rvsc.1999.0370google scholar: lookup
  7. Koblik PD, LeCouteur RA, Higgins RJ, Fick J, Kortz GD, Sturges BK, Pascoe PJ. Modification and application of a Pelorus Mark III stereotactic system for CT-guided brain biopsy in 50 dogs.. Vet Radiol Ultrasound 1999 Sep-Oct;40(5):424-33.
  8. Koblik PD, LeCouteur RA, Higgins RJ, Bollen AW, Vernau KM, Kortz GD, Ilkiw JE. CT-guided brain biopsy using a modified Pelorus Mark III stereotactic system: experience with 50 dogs.. Vet Radiol Ultrasound 1999 Sep-Oct;40(5):434-40.
  9. Rossmeisl JH, Andriani RT, Cecere TE, Lahmers K, LeRoith T, Zimmerman KL, Gibo D, Debinski W. Frame-Based Stereotactic Biopsy of Canine Brain Masses: Technique and Clinical Results in 26 Cases.. Front Vet Sci 2015;2:20.
    pmc: PMC4672202pubmed: 26664949doi: 10.3389/fvets.2015.00020google scholar: lookup
  10. Johnston GM, Eastment JK, Wood J, Taylor PM. The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.. Vet Anaesth Analg 2002 Oct;29(4):159-170.
  11. Bettschart R, Johnston M. Confidential enquiry into perioperative equine fatalities: CEPEF 4--a chance to gain new evidence about the risks of equine general anaesthesia.. Equine Vet J 2012 Jan;44(1):7.
  12. Dugdale AH, Obhrai J, Cripps PJ. Twenty years later: a single-centre, repeat retrospective analysis of equine perioperative mortality and investigation of recovery quality.. Vet Anaesth Analg 2016 Mar;43(2):171-8.
    pubmed: 26081190doi: 10.1111/vaa.12285google scholar: lookup
  13. Wang M, Song Z. How does adding anatomical landmarks as fiducial points in the point-matching registration of neuronavigation influence registration accuracy?. Comput Assist Surg (Abingdon) 2016 Dec;21(1):39-45.
    pubmed: 27973955doi: 10.1080/24699322.2016.1180429google scholar: lookup
  14. Gerard IJ, Hall JA, Mok K, Collins DL. New Protocol for Skin Landmark Registration in Image-Guided Neurosurgery: Technical Note.. Neurosurgery 2015 Sep;11 Suppl 3:376-80; discussion 380-1.
    pubmed: 26120798doi: 10.1227/neu.0000000000000868google scholar: lookup
  15. Frey S, Comeau R, Hynes B, Mackey S, Petrides M. Frameless stereotaxy in the nonhuman primate.. Neuroimage 2004 Nov;23(3):1226-34.
  16. Frey S, Mackey S, Petrides M. Cortico-cortical connections of areas 44 and 45B in the macaque monkey.. Brain Lang 2014 Apr;131:36-55.
    pubmed: 24182840doi: 10.1016/j.bandl.2013.05.005google scholar: lookup
  17. Kajikawa Y, Frey S, Ross D, Falchier A, Hackett TA, Schroeder CE. Auditory properties in the parabelt regions of the superior temporal gyrus in the awake macaque monkey: an initial survey.. J Neurosci 2015 Mar 11;35(10):4140-50.
  18. Johnston JM, Cohen YE, Shirley H, Tsunada J, Bennur S, Christison-Lagay K, Veeder CL. Recent refinements to cranial implants for rhesus macaques (Macaca mulatta).. Lab Anim (NY) 2016 May;45(5):180-6.
    pmc: PMC5428389pubmed: 27096188doi: 10.1038/laban.997google scholar: lookup
  19. Nitzsche B, Frey S, Collins LD, Seeger J, Lobsien D, Dreyer A, Kirsten H, Stoffel MH, Fonov VS, Boltze J. A stereotaxic, population-averaged T1w ovine brain atlas including cerebral morphology and tissue volumes.. Front Neuroanat 2015;9:69.
    pmc: PMC4455244pubmed: 26089780doi: 10.3389/fnana.2015.00069google scholar: lookup
  20. Boltze J, Ferrara F, Hainsworth AH, Bridges LR, Zille M, Lobsien D, Barthel H, McLeod DD, Gräßer F, Pietsch S, Schatzl AK, Dreyer AY, Nitzsche B. Lesional and perilesional tissue characterization by automated image processing in a novel gyrencephalic animal model of peracute intracerebral hemorrhage.. J Cereb Blood Flow Metab 2019 Dec;39(12):2521-2535.
    pmc: PMC6893983pubmed: 30239258doi: 10.1177/0271678x18802119google scholar: lookup
  21. Staudacher A, Oevermann A, Stoffel MH, Gorgas D. Validation of a magnetic resonance imaging guided stereotactic access to the ovine brainstem.. BMC Vet Res 2014 Sep 22;10:216.
    pmc: PMC4177427pubmed: 25241810doi: 10.1186/s12917-014-0216-5google scholar: lookup
  22. Vanschandevijl K, Gielen I, Nollet H, Vlaminck L, Deprez P, van Bree H. Computed tomography-guided brain biopsy for in vivo diagnosis of a cholesterinic granuloma in a horse.. J Am Vet Med Assoc 2008 Sep 15;233(6):950-4.
    pubmed: 18795858doi: 10.2460/javma.233.6.950google scholar: lookup
  23. Kramer J, Coates JR, Hoffman AG, Frappier BL. Preliminary anatomic investigation of three approaches to the equine cranium and brain for limited craniectomy procedures.. Vet Surg 2007 Jul;36(5):500-8.
  24. Vanhaezebrouck IF, Ballegeer EA, Frey S, Sieffert R. Accuracy and Precision of a Veterinary Neuronavigation System for Radiation Oncology Positioning.. J Vet Med 2018;2018:6431749.
    pmc: PMC5831826pubmed: 29666822doi: 10.1155/2018/6431749google scholar: lookup
  25. Mert A, Gan LS, Knosp E, Sutherland GR, Wolfsberger S. Advanced cranial navigation.. Neurosurgery 2013 Jan;72 Suppl 1:43-53.
    pubmed: 23254812doi: 10.1227/neu.0b013e3182750c03google scholar: lookup
  26. Moissonnier P, Blot S, Devauchelle P, Delisle F, Beuvon F, Boulha L, Colle MA, Lefrancois T. Stereotactic CT-guided brain biopsy in the dog.. J Small Anim Pract 2002 Mar;43(3):115-23.
  27. Kani Y, Cecere TE, Lahmers K, LeRoith T, Zimmerman KL, Isom S, Hsu FC, Debinksi W, Robertson JL, Rossmeisl JH. Diagnostic accuracy of stereotactic brain biopsy for intracranial neoplasia in dogs: Comparison of biopsy, surgical resection, and necropsy specimens.. J Vet Intern Med 2019 May;33(3):1384-1391.
    pmc: PMC6524398pubmed: 30990928doi: 10.1111/jvim.15500google scholar: lookup
  28. Wininger F. Neuronavigation in small animals: development, techniques, and applications.. Vet Clin North Am Small Anim Pract 2014 Nov;44(6):1235-48.
    pubmed: 25245183doi: 10.1016/j.cvsm.2014.07.015google scholar: lookup
  29. Lindsey C, Aschenbroich SA, Credille BC, Barton MH, Howerth EW. Pathology in Practice. Ependymoma of the right lateral ventricle with internal hydrocephalus in a horse.. J Am Vet Med Assoc 2015 May 15;246(10):1067-9.
    pubmed: 25932931doi: 10.2460/javma.246.10.1067google scholar: lookup
  30. Borel N, Grest P, Junge H, Wehrli Eser M. Vascular hamartoma in the central nervous system of a foal.. J Vet Diagn Invest 2014 Nov;26(6):805-9.
    pubmed: 25261460doi: 10.1177/1040638714548681google scholar: lookup
  31. Jackson CA, deLahunta A, Dykes NL, Divers TJ. Neurological manifestation of cholesterinic granulomas in three horses.. Vet Rec 1994 Sep 3;135(10):228-30.
    pubmed: 7801440doi: 10.1136/vr.135.10.228google scholar: lookup
  32. Vink-Nooteboom M, Junker K, van den Ingh TS, Dik KJ. Computed tomography of cholesterinic granulomas in the choroid plexus of horses.. Vet Radiol Ultrasound 1998 Nov-Dec;39(6):512-6.
  33. Johnson PJ, Lin TL, Jennings DP. Diffuse cerebral encephalopathy associated with hydrocephalus and cholesterinic granulomas in a horse.. J Am Vet Med Assoc 1993 Sep 1;203(5):694-7.
    pubmed: 8407539
  34. Divers TJ. Structural and functional disease of the equine brain. Clin Tech Equine Pract 2006;5:67‐73.
  35. Cobb S. Studies in mammalia neuropathology: 1. Cerebral cholesteatoma in the horse. J Mammal 1923;4:221‐223.

Citations

This article has been cited 4 times.
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    doi: 10.1371/journal.pone.0342569pubmed: 41686759google scholar: lookup
  2. Klopfenstein Bregger MD, de Preux M, Brünisholz HP, Van der Vekens E, Schweizer D, Koch C. Cheek tooth repulsion aided by computer-assisted surgery in 16 equids. Front Vet Sci 2025;12:1571539.
    doi: 10.3389/fvets.2025.1571539pubmed: 41133193google scholar: lookup
  3. de Preux M, Precht C, Travaglini AT, Propadalo LM, Farra D, Vidondo B, Easley JT, Koch C. Influence of the Vertek aiming device on the surgical accuracy of computer-assisted drilling of the equine distal sesamoid bone-An experimental cadaveric study. Vet Surg 2025 Jan;54(1):118-128.
    doi: 10.1111/vsu.14176pubmed: 39445680google scholar: lookup
  4. Gutmann S, Heiderhoff M, Möbius R, Siegel T, Flegel T. Application accuracy of a frameless optical neuronavigation system as a guide for craniotomies in dogs. Acta Vet Scand 2023 Dec 14;65(1):54.
    doi: 10.1186/s13028-023-00720-ypubmed: 38098105google scholar: lookup