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Towards transcervical ultrasound image guidance for transoral robotic surgery

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

Abstract

Purpose

Trans-oral robotic surgery (TORS) using the da Vinci surgical robot is a new minimally-invasive surgery method to treat oropharyngeal tumors, but it is a challenging operation. Augmented reality (AR) based on intra-operative ultrasound (US) has the potential to enhance the visualization of the anatomy and cancerous tumors to provide additional tools for decision-making in surgery.

Methods

We propose a US-guided AR system for TORS, with the transducer placed on the neck for a transcervical view. Firstly, we perform a novel MRI-to-transcervical 3D US registration study, comprising (i) preoperative MRI to preoperative US registration, and (ii) preoperative to intraoperative US registration to account for tissue deformation due to retraction. Secondly, we develop a US-robot calibration method with an optical tracker and demonstrate its use in an AR system that displays anatomy models in the surgeon’s console in real-time.

Results

Our AR system achieves a projection error from the US to the stereo cameras of 27.14 and 26.03 pixels (image is 540\(\times \)960) in a water bath experiment. The average target registration error (TRE) for MRI to 3D US is 8.90 mm for the 3D US transducer and 5.85 mm for freehand 3D US, and the TRE for pre-intra operative US registration is 7.90 mm.

Conclusion

We demonstrate the feasibility of each component of the first complete pipeline for MRI-US-robot-patient registration for a proof-of-concept transcervical US-guided AR system for TORS. Our results show that trans-cervical 3D US is a promising technique for TORS image guidance.

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Notes

  1. We interpolate each centerline into 1000 points and report the average distance between the corresponding points.

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Acknowledgements

We thank the financial support from Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant and the Charles Laszlo Chair in Biomedical Engineering held by Dr. Salcudean. We thank David Black, Nicholas Rangga, and Angela Li for their help in CAD.

Funding

Natural Sciences and Engineering Research Council of Canada Discovery Grant and Charles Laszlo Chair in Biomedical Engineering held by Dr. Salcudean.

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Authors and Affiliations

  1. Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, Canada

    Wanwen Chen, Megha Kalia, Qi Zeng, Razeyeh Bagherinasab & Septimiu E. Salcudean

  2. Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada

    Emily H. T. Pang & Farahna Sabiq

  3. Division of Otolaryngology, Department of Surgery, Vancouver General Hospital, Vancouver, BC, Canada

    Thomas D. Milner & Eitan Prisman

Authors
  1. Wanwen Chen
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  2. Megha Kalia
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  3. Qi Zeng
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  9. Septimiu E. Salcudean
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Correspondence to Wanwen Chen.

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The authors have no conflicts of interest.

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This study was performed in line with the ethical standards and obtained institutional ethics approval. All participants gave informed consent.

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Chen, W., Kalia, M., Zeng, Q. et al. Towards transcervical ultrasound image guidance for transoral robotic surgery. Int J CARS 18, 1061–1068 (2023). https://doi.org/10.1007/s11548-023-02898-y

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