Novel smartphone assisted device for neurotargeting.

Introduction: Despite the widespread use of external ventricular drainage, revision rates, and associated complications are reported between 10 and 40%. Current available image-guided techniques using stereotaxy, endoscopy, or ultrasound for catheter placements remain time-consuming techniques. Also, brain targeting procedures in emergency setting are challenging. The development of an easy -to-use, portable, image-guided system could reduce the need for multiple passes and improve the rate of accurate catheter placement and other brain targeting interventions in emergency setting. This study aims to design a novel smartphone assisted device for external ventricular drainage (EVD) placement and neuronavigation. Technique: In this study, authors have designed a novel 3D system composed of 3D software based on Android operating system and 3D design of a device in Autodesk 3D max using simple cranial measurements by DICOM PACS software for data input from Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). We plan to utilize this software as a guide and as a replacement for far more advanced neuronavigation systems. We have designed and launched the pilot version of this software and tested and compared it by DICOM PACS and also in an artificial skull for accuracy assessment. Our evaluation confirmed high accuracy performance of this smartphone application compared with DICOM PACS software for initial surgical approach to candidates for EVD placement or other emergency setting procedures which require neurotargeting interventions. Also, our neurotargeting device's accuracy was tested using provided angles by the application, which results in acceptable performance. Conclusion: This smartphone application coupled with targeting device can be used in various settings such as EVD placement in hydrocephalus and in other brain targeting candidates in emergency settings. Also, it may be used in any emergency or neurosurgery department centers with no access to advanced neuro-imaging facilities, only using patient's simple cranial measures to achieve acceptable and highly accurate brain targeting compared with conventional, time consuming and costly techniques. We plan to expand this study to clinical trials for further evaluation.