Noctopus: a novel device and method for patient registration and navigation in image-guided cranial surgery.

Purpose: A patient registration and real-time surgical navigation system and a novel device and method (Noctopus) is presented. With any tracking system technology and a patient/target-specific registration marker configuration, submillimetric target registration error (TRE), high-precise application accuracy for single or multiple anatomical targets in image-guided neurosurgery or ENT surgery is realized.

Methods: The system utilizes the advantages of marker-based registration technique and allows to perform automatized patient registration using on the device attached and with patient scanned four fiducial markers. The best possible sensor/marker positions around the patient's head are determined for single or multiple region(s) of interest (target/s) in the anatomy. Once brought at the predetermined positions the device can be operated with any tracking system for registration purposes.

Results: Targeting accuracy was evaluated quantitatively at various target positions on a phantom skull. The target registration error (TRE) was measured on individual targets using an electromagnetic tracking system. The overall averaged TRE was 0.22 ± 0.08 mm for intraoperative measurements.

Conclusion: An automatized patient registration system using optimized patient-/target-specific marker configurations is proposed. High-precision and user-error-free intraoperative surgical navigation with minimum number of registration markers and sensors is realized. The targeting accuracy is significantly improved in minimally invasive neurosurgical and ENT interventions.