Prospective stereotaxy: A novel method of trajectory alignment using real-time image guidance

Purpose: To describe prospective stereotaxy, a novel method of trajectory a lignment that works in real-time. Materials and Methods: Prospective stereotaxy was used In minimally-invasiv e neurosurgical procedures in 74 patients since February 1999. This methodo logy differs from framed and frameless stereotaxy, both of which are based on retrospective data. Rather, prospective stereotaxy uses real-time MR ima ges to align a surgical trajectory. Results: Phantom tests and clinical procedures in all patients were success fully performed using prospective stereotaxy. In all cases. surgical target s were accessed, and the diagnostic yield of neurobiopsy using prospective stereotaxy was 100%. Conclusion: Prospective stereotaxy is applicable to all cross-sectional ima ging, and is particularly useful for MR- and CT-guided interventions. The m ethod is simple, reproducible, and accurate in surgical targeting for neuro biopsy and electrode placement. It does not require cumbersome stereotactic frames or expensive optical detectors, and it offers immediate entry into the field of interventional MR with cylindrical MR scanners. (C) 2001 Wiley -Liss, Inc.