Alterations in Surgical Plan Based on Intraoperative Portable Head Computed Tomography Imaging

BACKGROUND Intraoperative imaging offers potential for utility in many clinical scenarios. Portable computed tomography (CT) offers a versatile potential alternative when immediate imaging may alter the surgical plan and magnetic resonance imaging is not practical. METHODS The medical records from the University or New Mexico were reviewed for portable head CT scans done in the operating room since the scanner has been available. Operative reports and imaging studies were reviewed to determine changes in surgical decision after the CT scan. FINDINGS The portable head CT scanner was used in 50 cases from May 2007 through March 2010. Average operative time overall was 121 minutes and for reservoir placement was 54 minutes. Procedures included reservoir placement (28%), tumor resection (24%), cerebrospinal fluid shunting (24%), vascular lesion resection (8%), trauma craniotomy (6%), abscess drainage (4%), stereotactic biopsy (4%), and open reduction internal fixation of facial fractures (2%). Findings on the CT scan lead to alterations in the surgical plan 16 times (32%). CONCLUSION In select cases, intraoperative portable head CT leads to changes in the surgical plan in 32% of cases. This potentially prevents a return to the operating room and offers a cost-effective alternative to fixed intraoperative imaging facilities.