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Evaluation of a portable image overlay projector for the visualisation of surgical navigation data: phantom studies

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Introduction

Presenting visual feedback for image-guided surgery on a monitor requires the surgeon to perform time-consuming comparisons and diversion of sight and attention away from the patient. Deficiencies in previously developed augmented reality systems for image-guided surgery have, however, prevented the general acceptance of any one technique as a viable alternative to monitor displays. This work presents an evaluation of the feasibility and versatility of a novel augmented reality approach for the visualisation of surgical planning and navigation data. The approach, which utilises a portable image overlay device, was evaluated during integration into existing surgical navigation systems and during application within simulated navigated surgery scenarios.

Methods

A range of anatomical models, surgical planning data and guidance information taken from liver surgery, cranio-maxillofacial surgery, orthopaedic surgery and biopsy were displayed on patient-specific phantoms, directly on to the patient’s skin and on to cadaver tissue. The feasibility of employing the proposed augmented reality visualisation approach in each of the four tested clinical applications was qualitatively assessed for usability, visibility, workspace, line of sight and obtrusiveness.

Results

The visualisation approach was found to assist in spatial understanding and reduced the need for sight diversion throughout the simulated surgical procedures. The approach enabled structures to be identified and targeted quickly and intuitively. All validated augmented reality scenes were easily visible and were implemented with minimal overhead. The device showed sufficient workspace for each of the presented applications, and the approach was minimally intrusiveness to the surgical scene.

Conclusion

The presented visualisation approach proved to be versatile and applicable to a range of image-guided surgery applications, overcoming many of the deficiencies of previously described AR approaches. The approach presents an initial step towards a widely accepted alternative to monitor displays for the visualisation of surgical navigation data.

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References

  1. Hansen C, Wieferich J, Ritter F, Rieder C, Peitgen H-O (2010) Illustrative visualization of 3D planning models for augmented reality in liver surgery. Int J Comput Assist Radiol Surg 5: 133–141

    Article  PubMed  Google Scholar 

  2. Sugimoto M, Yasuda H, Koda K, Suzuki M, Yamazaki M, Tezuka T, Kosugi C, Higuchi R, Watayo Y, Yagawa Y, Uemura S, Tsuchiya H, Azuma T (2010) Image overlay navigation by markerless surface registration in gastrointestinal, hepatobiliary and pancreatic surgery. J Hepato Biliary Pancreat Sci 17: 629–636

    Article  Google Scholar 

  3. Weber S, Klein M, Hein A, Krueger T, Lueth T, Bier J (2003) The navigated image viewer—evaluation in maxillofacial surgery. Medical image computing and computer-assisted intervention—MICCAI 2003, lecture notes in computer science, vol 2878, pp 762–769

  4. Wagner A, Rasse M, Millesi W, Ewers R (1997) Virtual reality for orthognathic surgery: the augmented reality environment concept. J Oral Maxillofac Surg 55: 456–462 (discussion 462–463)

    Google Scholar 

  5. Nikou C, Digioia A, Blackwell M, Jaramaz B, Kanade T (2000) Augmented reality imaging technology for orthopaedic surgery. Oper Techniq Orthopaed 10: 82–86

    Article  Google Scholar 

  6. Blackwell M, Morgan F, DiGioia AM (1998) Augmented reality and its future in orthopaedics. Clin Orthopaed Related Res 354: 111–122

    Article  Google Scholar 

  7. Schwald B, Seibert H, Schnaider M, Wesarg S, Roddiger S, Dogan S (2004) Implementation and Evaluation of an Augmented Reality System Supporting Minimal Invasive Interventions. Workshop AMI-ARCS. Online Proceedings : Augmented Environments for Medical Imaging, 2004, pp. 41-48

  8. Liao H, Ishihara H, Tran HH, Masamune K, Sakuma I, Dohi T (2010) Precision-guided surgical navigation system using laser guidance and 3D autostereoscopic image overlay. Comput Med Imaging Graph 34: 46–54

    Article  PubMed  Google Scholar 

  9. Marescaux J, Rubino F, Arenas M, Mutter D, Soler L (2004) Augmented-reality-assisted laparoscopic adrenalectomy. JAMA 292: 2214–2215

    Article  PubMed  CAS  Google Scholar 

  10. Fuchs H, State A, Yang H, Peck T, Lee SW, Rosenthal M, Bulysheva A, Burke C (2008) Optimizing a head-tracked stereo display system to guide hepatic tumor ablation. Stud Health Technol Inform 132: 126–131

    PubMed  Google Scholar 

  11. Sauer F, Khamene A, Bascle B, Schinunang L, Wenzel F, Vogt S (2001) Augmented reality visualization of ultrasound images: system description, calibration, and features. In: Proceedings IEEE and ACM international symposium on augmented reality. IEEE Computer Society, pp 30–39

  12. Volonte F, Bucher P, Pugin F, Carecchio A, Sugimoto M, Ratib O, Morel P (2010) Mixed reality for laparoscopic distal pancreatic resection. Int J Comput Assist Radiol Surg 5: 126–127

    Google Scholar 

  13. Tardif J-P, Roy S, Meunier J (2003) Projector-based augmented reality in surgery without calibration. In: Proceedings of the 25th annual international conference of the IEEE engineering in medicine and biology society, vol 1, pp 548–551

  14. Gavaghan KA, Peterhans M, Oliveira-Santos T, Weber S (2011) A portable image overlay projection device for computer-aided open liver surgery. in: IEEE Trans Biomed Eng 58: 1855–1864

    Article  Google Scholar 

  15. Zhang Z (2000) A flexible new technique for camera calibration. in: IEEE Trans Pattern Anal Mach Intell 22: 1330–1334

    Article  Google Scholar 

  16. Peterhans M, vom Berg A, Dagon B, Inderbitzin D, Baur C, Candinas D, Weber S (2011) A navigation system for open liver surgery: design, workflow and first clinical applications. Int J Med Robotics Comput Assist Surg 7: 7–16

    Article  CAS  Google Scholar 

  17. Oliveira-Santos T, Klaeser B, Weitzel T, Krause T, Nolte L-peter, Peterhans M, Weber S (2011) A navigation system for percutaneous needle interventions based on PET/CT images: Design, workflow and error analysis of soft tissue and bone punctures. Comput Aided Surg 16: 203–219

    Article  PubMed  Google Scholar 

  18. Schenk A, Zidowitz S, Bourquain H, Hindennach M, Hansen C, Hahn HK, Peitgen H-O (2008) Clinical relevance of model based computer-assisted diagnosis and therapy. In: Proceedings of SPIE, vol 6915, p 691502. doi:10.1117/12.780270

  19. Tucker S, Cevidanes LHS, Styner M, Kim H, Reyes M, Proffit W, Turvey T (2010) Comparison of actual surgical outcomes and 3-dimensional surgical simulations. J Oral Maxill Surg 68: 2412–2421

    Article  Google Scholar 

  20. Bou Sleiman H, Ritacco LE, Aponte-Tinao L, Muscolo DL, Nolte L-P, Reyes M (2011) Allograft selection for transepiphyseal tumor resection around the knee using three-dimensional surface registration. Ann Biomed Eng 39: 1720–1727

    Article  PubMed  Google Scholar 

  21. Markert M, Koschany A, Lueth T (2010) Tracking of the liver for navigation in open surgery. Int J CARS 5: 229–235

    Article  Google Scholar 

  22. Oliveira-Santos T, Peterhans M, Hofmann S, Weber S (2011) Passive single marker tracking for organ motion and deformation detection in open liver surgery. In: Taylor RH, Yang G-Z (eds) Information processing in computer-assisted interventions, Berlin, Germany. Springer, Berlin, pp 156–167

    Chapter  Google Scholar 

  23. Cash DM, Miga MI, Sinha TK, Galloway RL, Chapman WC (2005) Compensating for intraoperative soft-tissue deformations using incomplete surface data and finite elements. in: IEEE Trans Med Imaging 24: 1479–1491

    Article  Google Scholar 

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Gavaghan, K., Oliveira-Santos, T., Peterhans, M. et al. Evaluation of a portable image overlay projector for the visualisation of surgical navigation data: phantom studies. Int J CARS 7, 547–556 (2012). https://doi.org/10.1007/s11548-011-0660-7

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  • DOI: https://doi.org/10.1007/s11548-011-0660-7

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