Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | https://ri.ufs.br/jspui/handle/riufs/18495 |
Resumo: | The performance of less invasive and therefore less bloody neurosurgical approaches requires precise methods of locating points on the surface of the skull derived from the evaluation of imaging exams. In countries with limited resources for health, it is necessary to develop low- cost alternatives. This work aims to develop smartphone applications to guide minimally invasive neurosurgery craniotomies and to evaluate the accuracy and precision of the developed tools. The project in question consisted of four phases: two experimental stages and two clinical ones. Neurokeypoint application was developed, with the React Native framework for Android and iOS platforms, and Neurokeypoint AR, in Swift programming language. From a randomly selected CT of the normal skull, a head model was printed on a Z-Corp Model 310 Rapid Prototyping System 3D printer. Twelve fiducial adhesives were fixed in this model, which was then submitted to a new CT, used for accuracy assessment. The clinical phases consisted of non-probabilistic convenience samples with prospective data collection. After development, the Neurokeyoint application remained operationally stable on both Android and iOS mobile platforms. Associated with a compass, the overall mean target registrations error (TRE) was 1.6 ± 1.0 mm. There was also no relevant difference between test and retest (1.7 ± 1.1 vs 1.4 ± 0.9 mm, p = 0.340). The Neurokeypoint AR application, using augmented reality, was developed exclusively for iOS and, under optimized environmental conditions, obtained an average TRE of 2.6 ± 1.6 mm with iPhone 6s and 2.4 ± 1.2 mm with iPhone 12 Pro. In the clinical stages, 122 patients had their surgical plans using the developed tools (88 with neurokeypoint and 34 with neurokeypoint AR). With Neurokeypoint, 41 tumors (24 gliomas, 13 metastases and 4 meningiomas), 17 traumatic brain injuries, 16 spontaneous intraparenchymal hematomas, seven ventriculoperitoneal shunts, four abscesses, two cavernomas and one arteriovenous malformation were operated on. Thirty-four patients were operated using Neurokeypoint AR as a planning tool. They had the following diseases: thirteen intracranial metastases, nine meningiomas, seven gliomas and five intraparenchymal hematomas. Craniotomies assisted by Neurokeypoint AR had a mean diameter of 4.3 ± 1.9 cm, ranging from 2.5 to 10.4 cm. The incisions were mostly straight (55.9%). All cases of meningiomas, 12 metastases and 4 cases of gliomas underwent gross total resection. The Neurokeypoint and Neurokeypoint AR applications have been successfully developed and enable both craniotomy and trephination approaches to head injuries in a precise, less invasive and low-cost manner. |
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Santos, Bruno Fernandes de OliveiraOliveira, Joselina Luzia Menezes2023-10-11T14:27:51Z2023-10-11T14:27:51Z2022SANTOS, Bruno Fernandes de Oliveira. Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE. 2022. 84f. Tese (doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2022.https://ri.ufs.br/jspui/handle/riufs/18495The performance of less invasive and therefore less bloody neurosurgical approaches requires precise methods of locating points on the surface of the skull derived from the evaluation of imaging exams. In countries with limited resources for health, it is necessary to develop low- cost alternatives. This work aims to develop smartphone applications to guide minimally invasive neurosurgery craniotomies and to evaluate the accuracy and precision of the developed tools. The project in question consisted of four phases: two experimental stages and two clinical ones. Neurokeypoint application was developed, with the React Native framework for Android and iOS platforms, and Neurokeypoint AR, in Swift programming language. From a randomly selected CT of the normal skull, a head model was printed on a Z-Corp Model 310 Rapid Prototyping System 3D printer. Twelve fiducial adhesives were fixed in this model, which was then submitted to a new CT, used for accuracy assessment. The clinical phases consisted of non-probabilistic convenience samples with prospective data collection. After development, the Neurokeyoint application remained operationally stable on both Android and iOS mobile platforms. Associated with a compass, the overall mean target registrations error (TRE) was 1.6 ± 1.0 mm. There was also no relevant difference between test and retest (1.7 ± 1.1 vs 1.4 ± 0.9 mm, p = 0.340). The Neurokeypoint AR application, using augmented reality, was developed exclusively for iOS and, under optimized environmental conditions, obtained an average TRE of 2.6 ± 1.6 mm with iPhone 6s and 2.4 ± 1.2 mm with iPhone 12 Pro. In the clinical stages, 122 patients had their surgical plans using the developed tools (88 with neurokeypoint and 34 with neurokeypoint AR). With Neurokeypoint, 41 tumors (24 gliomas, 13 metastases and 4 meningiomas), 17 traumatic brain injuries, 16 spontaneous intraparenchymal hematomas, seven ventriculoperitoneal shunts, four abscesses, two cavernomas and one arteriovenous malformation were operated on. Thirty-four patients were operated using Neurokeypoint AR as a planning tool. They had the following diseases: thirteen intracranial metastases, nine meningiomas, seven gliomas and five intraparenchymal hematomas. Craniotomies assisted by Neurokeypoint AR had a mean diameter of 4.3 ± 1.9 cm, ranging from 2.5 to 10.4 cm. The incisions were mostly straight (55.9%). All cases of meningiomas, 12 metastases and 4 cases of gliomas underwent gross total resection. The Neurokeypoint and Neurokeypoint AR applications have been successfully developed and enable both craniotomy and trephination approaches to head injuries in a precise, less invasive and low-cost manner.Abordagens neurocirúrgicas menos invasivas e, portanto, menos cruentas requerem métodos precisos de localização craniana a partir dos exames de imagem. Em países com limitações de recursos para a saúde, faz-se necessário o desenvolvimento de alternativas de baixo custo. Esse trabalho objetiva desenvolver aplicativos de smartphone para guiar craniotomias de neurocirurgias minimamente invasivas e avaliar a acurácia e a precisão das ferramentas desenvolvidas. O projeto em questão consistiu de quatro fases: duas etapas experimentais e duas etapas clínicas. Foram desenvolvidos os aplicativos Neurokeypoint, com o framework React Native para as plataformas Android e iOS, e Neurokeypoint AR, na linguagem de programação Swift. A partir de uma tomografia computadorizada (TC) de crânio normal, aleatoriamente selecionada, foi impresso um modelo de cabeça em impressora 3D Z-Corp Model 310 Rapid Prototyping System. Doze adesivos fiduciais foram fixados nesse modelo, submetido em seguida a nova TC, usada para avaliação de acurácia. As fases clínicas foram constituídas de amostras não probabilísticas por conveniência com coleta de dados prospectiva. Após desenvolvimento, o aplicativo Neurokeyoint manteve-se operacionalmente estável em ambas as plataformas móveis Android e iOS. Associado a um compasso, a média geral do erro de registro do alvo (ERA) foi de 1,6 ± 1,0 mm. Também não houve diferença relevante entre o teste e o reteste (1,7 ± 1,1 vs 1,4 ± 0,9, p = 0,340). O aplicativo Neurokeypoint AR, com uso de realidade aumentada, foi desenvolvido exclusivamente para iOS e, em condições ambientais otimizadas, obteve ERA médio de 2,6 ± 1,6 mm com iPhone 6s e de 2,4 ± 1,2 mm com iPhone 12 Pro. Nas etapas clínicas, 122 pacientes tiveram seus planejamentos cirúrgicos com a utilização das ferramentas desenvolvidas (88 com neurokeypoint e 34 com neurokeypoint AR). Com o Neurokeypoint foram operados 41 tumores (24 gliomas, 13 metástases e 4 meningiomas), dezessete traumatismos cranioencefálicos, dezesseis hematomas intraparenquimatosos espontâneos, sete derivações ventriculoperitoneais, quatro abscessos, dois cavernomas e uma malformação arteriovenosa. Trinta e quatro pacientes foram operados utilizando o Neurokeypoint AR como ferramenta de planejamento. Apresentavam as seguintes enfermidades: treze metástases intracranianas, nove meningiomas, sete gliomas e cinco hematomas intraparenquimatosos. As craniotomias assistidas pelo Neurokeypoint AR tiveram diâmetro médio de 4,3 ± 1,9 cm, variando de 2,5 a 10,4 cm. Já as incisões foram em sua maioria retilíneas (55,9%). Todos os casos de meningiomas, 12 metástastases e 4 casos de gliomas tiveram ressecção radical. Os aplicativos Neurokeypoint e Neurokeypoint AR foram desenvolvidos com sucesso e possibilitam abordagens de lesões cranianas tanto por craniotomia quanto por trepanação de modo preciso, menos invasivo e com baixo custo.AracajuporProcedimentos neurocirúrgicosCirurgia assistida por computadorNeuronavegaçãoImagem tridimensionalProcedimentos cirúrgicos minimamente invasivosSmartphoneSoftwareNeurosurgical proceduresComputer-Assisted surgeryNeuronavigationThree-Dimensional imagingMinimally invasive surgical proceduresSmartphoneSoftwareCIENCIAS DA SAUDE::MEDICINANova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONEinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/18495/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALBruno_Santos.pdfBruno_Santos.pdfapplication/pdf5721763https://ri.ufs.br/jspui/bitstream/riufs/18495/2/Bruno_Santos.pdff4d9c12e8fd1a30defac1a7f312e3784MD52riufs/184952023-10-11 11:27:56.595oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2023-10-11T14:27:56Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
title |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
spellingShingle |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE Santos, Bruno Fernandes de Oliveira Procedimentos neurocirúrgicos Cirurgia assistida por computador Neuronavegação Imagem tridimensional Procedimentos cirúrgicos minimamente invasivos Smartphone Software Neurosurgical procedures Computer-Assisted surgery Neuronavigation Three-Dimensional imaging Minimally invasive surgical procedures Smartphone Software CIENCIAS DA SAUDE::MEDICINA |
title_short |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
title_full |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
title_fullStr |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
title_full_unstemmed |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
title_sort |
Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE |
author |
Santos, Bruno Fernandes de Oliveira |
author_facet |
Santos, Bruno Fernandes de Oliveira |
author_role |
author |
dc.contributor.author.fl_str_mv |
Santos, Bruno Fernandes de Oliveira |
dc.contributor.advisor1.fl_str_mv |
Oliveira, Joselina Luzia Menezes |
contributor_str_mv |
Oliveira, Joselina Luzia Menezes |
dc.subject.por.fl_str_mv |
Procedimentos neurocirúrgicos Cirurgia assistida por computador Neuronavegação Imagem tridimensional Procedimentos cirúrgicos minimamente invasivos Smartphone Software |
topic |
Procedimentos neurocirúrgicos Cirurgia assistida por computador Neuronavegação Imagem tridimensional Procedimentos cirúrgicos minimamente invasivos Smartphone Software Neurosurgical procedures Computer-Assisted surgery Neuronavigation Three-Dimensional imaging Minimally invasive surgical procedures Smartphone Software CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Neurosurgical procedures Computer-Assisted surgery Neuronavigation Three-Dimensional imaging Minimally invasive surgical procedures Smartphone Software |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
The performance of less invasive and therefore less bloody neurosurgical approaches requires precise methods of locating points on the surface of the skull derived from the evaluation of imaging exams. In countries with limited resources for health, it is necessary to develop low- cost alternatives. This work aims to develop smartphone applications to guide minimally invasive neurosurgery craniotomies and to evaluate the accuracy and precision of the developed tools. The project in question consisted of four phases: two experimental stages and two clinical ones. Neurokeypoint application was developed, with the React Native framework for Android and iOS platforms, and Neurokeypoint AR, in Swift programming language. From a randomly selected CT of the normal skull, a head model was printed on a Z-Corp Model 310 Rapid Prototyping System 3D printer. Twelve fiducial adhesives were fixed in this model, which was then submitted to a new CT, used for accuracy assessment. The clinical phases consisted of non-probabilistic convenience samples with prospective data collection. After development, the Neurokeyoint application remained operationally stable on both Android and iOS mobile platforms. Associated with a compass, the overall mean target registrations error (TRE) was 1.6 ± 1.0 mm. There was also no relevant difference between test and retest (1.7 ± 1.1 vs 1.4 ± 0.9 mm, p = 0.340). The Neurokeypoint AR application, using augmented reality, was developed exclusively for iOS and, under optimized environmental conditions, obtained an average TRE of 2.6 ± 1.6 mm with iPhone 6s and 2.4 ± 1.2 mm with iPhone 12 Pro. In the clinical stages, 122 patients had their surgical plans using the developed tools (88 with neurokeypoint and 34 with neurokeypoint AR). With Neurokeypoint, 41 tumors (24 gliomas, 13 metastases and 4 meningiomas), 17 traumatic brain injuries, 16 spontaneous intraparenchymal hematomas, seven ventriculoperitoneal shunts, four abscesses, two cavernomas and one arteriovenous malformation were operated on. Thirty-four patients were operated using Neurokeypoint AR as a planning tool. They had the following diseases: thirteen intracranial metastases, nine meningiomas, seven gliomas and five intraparenchymal hematomas. Craniotomies assisted by Neurokeypoint AR had a mean diameter of 4.3 ± 1.9 cm, ranging from 2.5 to 10.4 cm. The incisions were mostly straight (55.9%). All cases of meningiomas, 12 metastases and 4 cases of gliomas underwent gross total resection. The Neurokeypoint and Neurokeypoint AR applications have been successfully developed and enable both craniotomy and trephination approaches to head injuries in a precise, less invasive and low-cost manner. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2023-10-11T14:27:51Z |
dc.date.available.fl_str_mv |
2023-10-11T14:27:51Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
SANTOS, Bruno Fernandes de Oliveira. Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE. 2022. 84f. Tese (doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2022. |
dc.identifier.uri.fl_str_mv |
https://ri.ufs.br/jspui/handle/riufs/18495 |
identifier_str_mv |
SANTOS, Bruno Fernandes de Oliveira. Nova tecnologia para neurocirurgias minimamente invasivas guiadas por aplicativo de SMARTPHONE. 2022. 84f. Tese (doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2022. |
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Pós-Graduação em Ciências da Saúde |
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