Augmented Reality Navigation System (SIRIO) for Neuroprotection in Vertebral Tumoral Ablation
<p>Axial (<b>A</b>) image demonstrating a secondary osteolytic lesion from breast cancer located in the spinal process of D8. Sagittal (<b>B</b>) and axial (<b>C</b>) images showing epidural dissection with CO<sub>2</sub> and contrast medium.</p> "> Figure 2
<p>Axial images demonstrating the positioning of two probes in the spinal process of D8 (<b>A</b>) and the adjacent epidural dissection obtained (<b>B</b>).</p> "> Figure 3
<p>Comparison of SIRIO Assisted vs. non-SIRIO Assisted epidural dissections: (<b>A</b>): Comparison of Dose-Length Product (DLP) between SIRIO-assisted and non-SIRIO-assisted procedures. The boxplot shows significantly lower DLP values for SIRIO-assisted procedures, indicating reduced radiation exposure. (<b>B</b>): Comparison of Procedural Time between SIRIO-assisted and non-SIRIO-assisted procedures. The boxplot indicates that procedural time is significantly shorter for SIRIO-assisted procedures. (<b>C</b>): Comparison of Procedural Pain (VAS Time 0) between SIRIO-assisted and non-SIRIO-assisted procedures. The boxplot suggests no significant difference in immediate procedural pain between the two groups. (<b>D</b>): Comparison of Pain at Three Months (VAS Time 1) between SIRIO-assisted and non-SIRIO-assisted procedures. The boxplot shows no significant difference in pain reduction at three months post-procedure between the two groups.</p> "> Figure 4
<p>Impact of Predictors on DLP and Procedural Time. (<b>A</b>): Bar chart showing the impact of predictors (Age, Vertebroplasty Procedure, Tumor Type, SIRIO Assistance) on DLP. The SIRIO Assistance has the most significant negative impact on DLP. (<b>B</b>): Bar chart showing the impact of predictors (Age, Vertebroplasty Procedure, Tumor Type, SIRIO Assistance) on Procedural Time. SIRIO Assistance significantly reduces the procedural time.</p> "> Figure 5
<p>Relationship between Dimension of Lesion and VAS Time 1. (<b>A</b>): Scatter plot showing the relationship between the dimension of the treated lesion and the VAS score at three months post-procedure for SIRIO-assisted procedures. A positive correlation is observed, indicating that larger lesions tend to be associated with higher pain scores. (<b>B</b>): Scatter plot showing the relationship between the dimension of the treated lesion and the VAS score at three months post-procedure for non-SIRIO assisted procedures. A similar positive correlation is observed, suggesting that larger lesions are associated with higher pain scores in both groups.</p> "> Figure 6
<p>VAS Time 1 by Age Group for SIRIO Assisted and Non-SIRIO Assisted Procedures. (<b>A</b>): Boxplot showing the distribution of VAS Time 1 scores across different age groups for SIRIO-assisted procedures. No significant differences were found between the age groups. (<b>B</b>): Boxplot showing the distribution of VAS Time 1 scores across different age groups for non-SIRIO assisted procedures. Significant differences were found between the age groups, particularly between <50 and 50–70, and <50 and >70.</p> "> Figure 7
<p>Axial (<b>A</b>) image demonstrating the presence of an osteoid osteoma located in adjacency to the inferior articular facet of D9. Axial (<b>B</b>) image demonstrating correct needle positioning and CO<sub>2</sub> epidural dissection.</p> ">
Abstract
:1. Introduction
2. Materials and Methods
- Procedural Time: Defined as the duration from the initial needle insertion to the completion of optimal dissection for safe ablative treatment;
- Patient Radiation Dose: Measured by the dose-length product (DLP) recorded during the neuroprotection procedure;
- Technical success: Percentage of tumors successfully treated, resulting in a complete ablation zone covering the target tumor, as depicted on immediate post-ablation imaging and first follow-up imaging (1 month);
- Complication Rates: Any adverse events occurring during or after the procedure were monitored and recorded;
- Pain Scores: Measured by the Visual Analog Scale (VAS) at procedural time (VAS Time 0) and three months post-procedure (VAS Time 1).
3. Statistical Analysis
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Group | Metric | Mean | Min | Median | Max |
---|---|---|---|---|---|
SIRIO | DLP (mGycm) | 307.42 ± 48.89 | 221 | 304 | 384 |
Procedural Time (min) | 13.48 ± 3.62 | 7.8 | 14.4 | 18.7 | |
Needle path (mm) | 46.33 ± 6.12 | 36 | 47 | 55 | |
Dimension of the lesion (mm) | 11.67 ± 8.05 | 6 | 8 | 28 | |
VAS 0 | 0.75 ± 0.45 | 0 | 1 | 1 | |
VAS 1 | 0.25 ± 0.45 | 0 | 0 | 1 | |
Non-SIRIO | DLP (mGycm) | 460.31 ± 32.82 | 402 | 457 | 526 |
Procedural Time (min) | 32.26 ± 4.44 | 27.1 | 32.5 | 35.6 | |
Needle path (mm) | 53.00 ± 3.23 | 49 | 54 | 56 | |
Dimension of the lesion (mm) | 23.50 ± 9.65 | 6 | 25 | 29 | |
VAS 0 | 0.69 ± 0.48 | 0 | 1 | 1 | |
VAS 1 | 0.31 ± 0.48 | 0 | 0 | 1 |
Metric | Test Used | Statistic | p-Value |
---|---|---|---|
DLP (mGy·cm) | Mann–Whitney U | 15.0 | 0.000186 |
Procedural Time (min) | Mann–Whitney U | 12.0 | 0.000105 |
VAS Time 0 | Mann–Whitney U | 86.0 | 0.643494 |
VAS Time 1 | Mann–Whitney U | 0.484 | 0.6321 |
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Faiella, E.; Casati, R.; Pileri, M.; Pacella, G.; Altomare, C.; Vergantino, E.; Bruno, A.; Beomonte Zobel, B.; Grasso, R.F. Augmented Reality Navigation System (SIRIO) for Neuroprotection in Vertebral Tumoral Ablation. Curr. Oncol. 2024, 31, 5088-5097. https://doi.org/10.3390/curroncol31090376
Faiella E, Casati R, Pileri M, Pacella G, Altomare C, Vergantino E, Bruno A, Beomonte Zobel B, Grasso RF. Augmented Reality Navigation System (SIRIO) for Neuroprotection in Vertebral Tumoral Ablation. Current Oncology. 2024; 31(9):5088-5097. https://doi.org/10.3390/curroncol31090376
Chicago/Turabian StyleFaiella, Eliodoro, Rebecca Casati, Matteo Pileri, Giuseppina Pacella, Carlo Altomare, Elva Vergantino, Amalia Bruno, Bruno Beomonte Zobel, and Rosario Francesco Grasso. 2024. "Augmented Reality Navigation System (SIRIO) for Neuroprotection in Vertebral Tumoral Ablation" Current Oncology 31, no. 9: 5088-5097. https://doi.org/10.3390/curroncol31090376