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Extra info for Advanced techniques in image-guided brain and spine surgery
15 the table positions corresponding to the image slices. Table position is accurately measured and recorded in current CT scanners. In our experience at several major university hospitals, quality assurance testing of CT scanners is very good and geometrical distortion in routinely acquired clinical CT image slices is very low. b A CT image volume is a stack of two-dimensional (2-D) image slices. If a CT image is acquired with the gantry tilted, and the image slices are simply stacked without accounting for the nonzero tilt angle, then the image volume will have a type of geometrical distortion called shear.
13 The image markers are constructed from hollow plastic cylinders that are filled with an aqueous solution of iothalamate meglumine and gadopentetate dimeglumine and sealed (B, left; C). The physical space markers (localization caps) are manufactured with a hemispherical divot whose position corresponds to the centroid of the image markers (B, right; D). The threaded ends of plastic marker bases or posts (B, center) are screwed into the outer table of the skull of the patient. (C). The image markers are attached to the bases during image acquisition.
Because CT image volumes are stacks of sequentially acquired slices, any patient movement between slices distorts the image. In addition to the normal difficulties of keeping a person still, head movement can be caused by inertial jerking during each table advance in conventional CT image acquisition. Helical CT image acquisition involves continuous patient translation during x-ray source rotation and produces a complete image volume in a relatively short period of time. Some current CT scanners feature multiple detector arrays; multislice helical CT image acquisition is extremely fast.