O-Arm Surgical Imaging System

Sunnybrook is a world leader in the treatment of musculoskeletal (MSK) trauma, arthroplasty and metastases. Intraoperative imaging has revolutionized MSK surgery and yielded significant improvements in clinical outcomes through reducing invasiveness and improving accuracy. However, intraoperative MSK imaging is most often used qualitatively in two dimensions (2-D) and requires high levels of training and experience. Better tools are needed to aid 3-D intraoperative visualization, accuracy and guidance to extend and optimize MSK procedures.

The O-arm is a mobile, isocentric, cone-beam computed tomography (CBCT) flat-panel detector system for intraoperative use. Integration of the O-arm with the StealthStation S7 Surgical Navigation System enables real-time intraoperative tracking of skeletal structures and tools. The StealthLink software allows image data from this system to be accessed directly to enable investigations of specialized image reconstruction techniques to improve hard and soft tissue visualization, essential for avoiding critical structures.

The following core equipment is available for use:

We can also provide opportunities for research fellows and students at Sunnybrook Research Institute to gain experience and training using intraoperative navigation. We encourage collaborative opportunities with investigators on research projects and support investigators’ grant applications.

Equipment

The O-arm Surgical Imaging System
  • 3-D, multi-plane fluoroscopic imaging capability, in addition to 2-D imaging.
  • Two levels of 3-D image acquisition using a 512 x 512 x 192 reconstruction matrix:
    • Standard definition 3-D imaging mode: Exposure time ~ 13 seconds, scan time taking 391 images over 360°
    • High definition 3-D imaging mode: Exposure time ~ 26 seconds, scan time taking 750 images over 360°, with better contrast and spatial resolution.
      ateral patient access without compromising mobility.
  • Fast imaging with automated real-time and pre-set positioning (M2D).
  • 2 K x 1.5 K digital flat-panel detector enables higher dynamic range and resolution.
  • Automated multiplane imaging eliminates manual repositioning or need for a second system.
  • System includes the O-arm Imaging Mobile View Station (MVS) stand with 30″ digital monitor.
  • DICOM 3.0 compliant: The system supports transfer of locally created images across the network to another system and can also save images to CD or DVD.
  • The O-arm system interfaces with StealthStation navigation systems. This solution provides automatic data transfer of the patient’s 3-D data set, as well as the anterior-posterior and lateral fluoroscopy images. Automatic patient registration on the StealthStation navigation system eliminates the need for lengthy patient registration and allows the surgeon to navigate immediately after image acquisition and data transfer.
StealthStation S7 Surgical Navigation System
  • Interfaces with multiple intraoperative imaging systems, including intraoperative magnetic resonance imaging, intraoperative computer tomography, C-arms and the O-arm
  • Optical surgical navigation
  • High-resolution, wide-screen monitor
  • Many options to access preoperative exams via CD, USB and DICOM query/retrieve
  • Product information sheet from Medtronic
StealthLink

Data available via StealthLink 1 include:

  • Tool transforms for multiple tools
  • Frame transforms
  • Image space to frame space registration transforms
  • Surgical plan target and entry points
  • Registration exam information
  • Working exam information (with merge transform to the registration exam)
  • Microscope information
  • Probe tip in image space
  • Functional procedure specific information
  • All transforms are float[4][4] and points are float[3]

StealthLink 2 application program interface supports a query/retrieve mechanism and contains a subscription mechanism for frequently updated data. The API consists of a C++ library and is available for Windows and Linux.

Data consist of data classes and methods to enable convenient access. All data will have an optional timestamp.

  • Instrument
  • Name, image space tip, transforms, marker information, status information, etc.
  • Frame
  • Registration
  • Name, transforms, point sets, etc.
  • Exam
  • Image set, properties, merge transforms, etc.
  • Planning information
  • Surgical plans, segmented models
  • Footswitch status, task information, localizer data

New PLUS toolkit includes a StealthLink/OpenIGTLink bridge for receiving live tool position information, planning image volume, registration results through StealthLink and sending it to Slicer through OpenIGTLink.

Service/EquipmentInternal FeeExternal fee
O-arm$100/hour*$200/hour*
Stealth S7 Navigation System$50/hour*$100/hour*
Technical assistance (preclinical)$50/hour$100/hour
Technical assistance (clinical)Procedure dependentProcedure dependent

*Please note that these are cost estimates. Additional costs apply to supplies and sterilization/cleaning. Final procedural costs may be dependent on length of use and number of images acquired.


Contact

Cari Whyne 416-480-5056