Laparoscopic augmented reality registration for oncological resection site repair

Abstract Purpose Resection site repair during laparoscopic oncological surgery (e.g. laparoscopic partial nephrectomy) poses some unique challenges and opportunities for augmented reality (AR) navigation support. This work introduces an AR registration workflow that addresses the time pressure that is present during resection site repair. Methods We propose a two-step registration process: the AR content is registered as accurately as possible prior to the tumour resection (the primary registration). This accurate registration is used to apply artificial fiducials to the physical organ and the virtual model. After the resection, these fiducials can be used for rapid re-registration (the secondary registration). We tested this pipeline in a simulated-use study with $$N=18$$ N = 18 participants. We compared the registration accuracy and speed for our method and for landmark-based registration as a reference. Results Acquisition of and, thereby, registration with the artificial fiducials were significantly faster than the initial use of anatomical landmarks. Our method also had a trend to be more accurate in cases in which the primary registration was successful. The accuracy loss between the elaborate primary registration and the rapid secondary registration could be quantified with a mean target registration error increase of 2.35 mm. Conclusion This work introduces a registration pipeline for AR navigation support during laparoscopic resection site repair and provides a successful proof-of-concept evaluation thereof. Our results indicate that the concept is better suited than landmark-based registration during this phase, but further work is required to demonstrate clinical suitability and applicability.

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Reliable navigation registration in cranial and spine surgery based on intraoperative computed tomography

Neurosurgical FOCUS ◽

10.3171/2019.8.focus19621 ◽

2019 ◽

Vol 47 (6) ◽

pp. E11 ◽

Cited By ~ 6

Author(s):

Barbara Carl ◽

Miriam Bopp ◽

Benjamin Saß ◽

Mirza Pojskic ◽

Marko Gjorgjevski ◽

...

Keyword(s):

Augmented Reality ◽

Radiation Exposure ◽

Effective Dose ◽

Low Dose ◽

Intraoperative Imaging ◽

Registration Accuracy ◽

Dose Length Product ◽

Registration Error ◽

Target Registration Error ◽

Patient Registration

OBJECTIVELow registration errors are an important prerequisite for reliable navigation, independent of its use in cranial or spinal surgery. Regardless of whether navigation is used for trajectory alignment in biopsy or implant procedures, or for sophisticated augmented reality applications, all depend on a correct registration of patient space and image space. In contrast to fiducial, landmark, or surface matching–based registration, the application of intraoperative imaging allows user-independent automatic patient registration, which is less error prone. The authors’ aim in this paper was to give an overview of their experience using intraoperative CT (iCT) scanning for automatic registration with a focus on registration accuracy and radiation exposure.METHODSA total of 645 patients underwent iCT scanning with a 32-slice movable CT scanner in combination with navigation for trajectory alignment in biopsy and implantation procedures (n = 222) and for augmented reality (n = 437) in cranial and spine procedures (347 craniotomies and 42 transsphenoidal, 56 frameless stereotactic, 59 frame-based stereotactic, and 141 spinal procedures). The target registration error was measured using skin fiducials that were not part of the registration procedure. The effective dose was calculated by multiplying the dose length product with conversion factors.RESULTSAmong all 1281 iCT scans obtained, 1172 were used for automatic patient registration (645 initial registration scans and 527 repeat iCT scans). The overall mean target registration error was 0.86 ± 0.38 mm (± SD) (craniotomy, 0.88 ± 0.39 mm; transsphenoidal, 0.92 ± 0.39 mm; frameless, 0.74 ± 0.39 mm; frame-based, 0.84 ± 0.34 mm; and spinal, 0.80 ± 0.28 mm). Compared with standard diagnostic scans, a distinct reduction of the effective dose could be achieved using low-dose protocols for the initial registration scan with mean effective doses of 0.06 ± 0.04 mSv for cranial, 0.50 ± 0.09 mSv for cervical, 4.12 ± 2.13 mSv for thoracic, and 3.37 ± 0.93 mSv for lumbar scans without impeding registration accuracy.CONCLUSIONSReliable automatic patient registration can be achieved using iCT scanning. Low-dose protocols ensured a low radiation exposure for the patient. Low-dose scanning had no negative effect on navigation accuracy.

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Holographic patient tracking after bed movement for augmented reality neuronavigation using a head-mounted display

Acta Neurochirurgica ◽

10.1007/s00701-021-04707-4 ◽

2021 ◽

Author(s):

T. Fick ◽

J.A.M. van Doormaal ◽

E.W. Hoving ◽

L. Regli ◽

T.P.C. van Doormaal

Keyword(s):

Augmented Reality ◽

Anatomical Landmarks ◽

Registration Accuracy ◽

Patient Tracking ◽

First Report ◽

Head Mounted Display ◽

Reference Array ◽

Custom Made ◽

Before And After ◽

Neuronavigation System

Abstract Background Holographic neuronavigation has several potential advantages compared to conventional neuronavigation systems. We present the first report of a holographic neuronavigation system with patient-to-image registration and patient tracking with a reference array using an augmented reality head-mounted display (AR-HMD). Methods Three patients undergoing an intracranial neurosurgical procedure were included in this pilot study. The relevant anatomy was first segmented in 3D and then uploaded as holographic scene in our custom neuronavigation software. Registration was performed using point-based matching using anatomical landmarks. We measured the fiducial registration error (FRE) as the outcome measure for registration accuracy. A custom-made reference array with QR codes was integrated in the neurosurgical setup and used for patient tracking after bed movement. Results Six registrations were performed with a mean FRE of 8.5 mm. Patient tracking was achieved with no visual difference between the registration before and after movement. Conclusions This first report shows a proof of principle of intraoperative patient tracking using a standalone holographic neuronavigation system. The navigation accuracy should be further optimized to be clinically applicable. However, it is likely that this technology will be incorporated in future neurosurgical workflows because the system improves spatial anatomical understanding for the surgeon.

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A proof-of-concept study on the impact of artificial hypergravity on force-adapted target sizing for direct Augmented Reality pointing

2014 IEEE Virtual Reality (VR) ◽

10.1109/vr.2014.6802068 ◽

2014 ◽

Author(s):

Daniela Markov-Vetter ◽

Vanja Zander ◽

Joachim Latsch ◽

Oliver Staadt

Keyword(s):

Augmented Reality ◽

Proof Of Concept ◽

Concept Study ◽

The Impact

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Proof of concept of a multimodal intravital molecular imaging system for tumour transpathology investigation

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05574-y ◽

2021 ◽

Author(s):

Zhen Liu ◽

Tao Cheng ◽

Stephan Düwel ◽

Ziying Jian ◽

Geoffrey J. Topping ◽

...

Keyword(s):

Molecular Imaging ◽

Imaging System ◽

Ex Vivo ◽

Fiducial Markers ◽

Proof Of Concept ◽

Registration Accuracy ◽

Microscopic Imaging ◽

Window Chamber

Abstract Background Transpathology highlights the interpretation of the underlying physiology behind molecular imaging. However, it remains challenging due to the discrepancies between in vivo and in vitro measurements and difficulties of precise co-registration between trans-scaled images. This study aims to develop a multimodal intravital molecular imaging (MIMI) system as a tool for in vivo tumour transpathology investigation. Methods The proposed MIMI system integrates high-resolution positron imaging, magnetic resonance imaging (MRI) and microscopic imaging on a dorsal skin window chamber on an athymic nude rat. The window chamber frame was designed to be compatible with multimodal imaging and its fiducial markers were customized for precise physical alignment among modalities. The co-registration accuracy was evaluated based on phantoms with thin catheters. For proof of concept, tumour models of the human colorectal adenocarcinoma cell line HT-29 were imaged. The tissue within the window chamber was sectioned, fixed and haematoxylin–eosin (HE) stained for comparison with multimodal in vivo imaging. Results The final MIMI system had a maximum field of view (FOV) of 18 mm × 18 mm. Using the fiducial markers and the tubing phantom, the co-registration errors are 0.18 ± 0.27 mm between MRI and positron imaging, 0.19 ± 0.22 mm between positron imaging and microscopic imaging and 0.15 ± 0.27 mm between MRI and microscopic imaging. A pilot test demonstrated that the MIMI system provides an integrative visualization of the tumour anatomy, vasculatures and metabolism of the in vivo tumour microenvironment, which was consistent with ex vivo pathology. Conclusions The established multimodal intravital imaging system provided a co-registered in vivo platform for trans-scale and transparent investigation of the underlying pathology behind imaging, which has the potential to enhance the translation of molecular imaging.

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Reviving Stories And Space Of The Past: Exploring New Opportunities In Mixed Media Storytelling

10.32920/ryerson.14652978 ◽

2021 ◽

Author(s):

Dawsyn Borland

Keyword(s):

Augmented Reality ◽

Informal Learning ◽

Mixed Media ◽

Historical Narrative ◽

Proof Of Concept ◽

Communication Tool ◽

House Museums ◽

The Past ◽

Historic House ◽

Multisensory Interactions

This project presents the idea that historic house museums (HHMs) can use Augmented Reality (AR) and physical interactive space to bring stories and characters of the past back to life. Designed to foster self-directed discovery and informal learning of the space and story, this project uses a historically factual AR character to reanimate the sense of human presence within the space. Rather than disrupting the traditional narratives of HHMs, this mixed media storytelling experience extends historical stories by making them more personal and relatable. Using tangible stories, multisensory interactions, and an AR experience to extend the historical narrative, this form of museological work creates more opportunities for empathic character-driven storytelling. Lastly, I identify that this proof of concept could be used in multiple applications, as both a storytelling medium and a communication tool.

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Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: A proof of concept study

Medical Engineering & Physics ◽

10.1016/j.medengphy.2018.02.007 ◽

2018 ◽

Vol 55 ◽

pp. 52-59 ◽

Cited By ~ 13

Author(s):

B.H. van Duren ◽

K. Sugand ◽

R. Wescott ◽

R. Carrington ◽

A. Hart

Keyword(s):

Augmented Reality ◽

Guide Wire ◽

Proof Of Concept ◽

Concept Study

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The relation between head circumference and mid pelvic circumference: A simple index for cephalo-pelvic disproportion evaluation

Fetal Diagnosis and Therapy ◽

10.1159/000521115 ◽

2021 ◽

Author(s):

Gad Liberty ◽

Ofer Gemer ◽

Irena Siyanov ◽

Eyal Y. Anteby ◽

Alona Apter ◽

...

Keyword(s):

Head Circumference ◽

Odds Ratio ◽

Proof Of Concept ◽

Fetal Head ◽

Simple Index ◽

Bony Pelvis ◽

Cesarean Deliveries ◽

Simple Tool ◽

Vaginal Deliveries ◽

Concept Evaluation

Introduction: Cephalo-pelvic-disproportion (CPD) is one of the most common obstetric complications. Since CPD is the disproportion between the fetal head and maternal bony pelvis, evaluation of the head-circumference (HC) relative to maternal bony pelvis may be a useful adjunct to pre-labor CPD evaluation. The aim of the present study was a proof-of-concept evaluation of the ratio between HC to pelvic circumference (PC) as a predictor of CPD. Methods: Of 11,822 deliveries, 104 cases that underwent an abdomino-pelvic CT for any medical indication and who underwent normal vaginal deliveries (NVD) (n=84) or cesarean deliveries (CD) due to CPD (n=20) were included retrospectively. Maternal pelvis dimensions were reconstructed and neonatal HC, as a proxy for fetal HC, were measured. The correlation between cases of CPD and Cephalo-Pelvic Circumference Index (CPCI), which represents the ratio between the HC and PC in percent (HC/PC *100) was evaluated. Results: The mid-pelvis cephalo-pelvic circumference index (MP-CPCI) was larger in CD groups as compared to the NVD group: 103±11 vs. 97±8% respectively (p=0.0003). In logistic regression analysis, the MP-CPCI was found to be independently associated with CD due to CPD: each 1% increase in MP-CPCI increased the likelihood of CD for CPD by 11% (aOR 1.11, CI 95% 1.03-1.19, p=0.004). The adjusted odds ratio for CD due to CPD increased incrementally as the MP-CPCI increased, from 3.56 (95%CI, 1.01-12.6) at MP-CPCI of 100, to 5.6 (95%CI, 1.63-19.45) at 105, 21.44 (95%CI, 3.05-150.84) at 110, and 28.88 (95%CI, 2.3-362.27) at MP-CPCI of 115 Conclusions: The MP-CPCI, representing the relative dimensions of the fetal HC and maternal PC, is a simple tool that can potentially distinguish between parturients at lower and higher risk of CPD. Prospective randomized studies are required to evaluate the feasibility of prenatal pelvimetry and MP-CPCI to predict the risk of CPD during labor.

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