Identification of the atrioventricular conduction axis and its positional relationship with anatomical landmarks of a heart with tricuspid atresia

Abstract Objective The rapid development of artificial intelligence technologies for medical imaging has recently enabled automatic identification of anatomical landmarks on radiographs. The purpose of this study was to compare the results of an automatic cephalometric analysis using convolutional neural network with those obtained by a conventional cephalometric approach. Material and methods Cephalometric measurements of lateral cephalograms from 35 patients were obtained using an automatic program and a conventional program. Fifteen skeletal cephalometric measurements, nine dental cephalometric measurements, and two soft tissue cephalometric measurements obtained by the two methods were compared using paired t test and Bland-Altman plots. Results A comparison between the measurements from the automatic and conventional cephalometric analyses in terms of the paired t test confirmed that the saddle angle, linear measurements of maxillary incisor to NA line, and mandibular incisor to NB line showed statistically significant differences. All measurements were within the limits of agreement based on the Bland-Altman plots. The widths of limits of agreement were wider in dental measurements than those in the skeletal measurements. Conclusions Automatic cephalometric analyses based on convolutional neural network may offer clinically acceptable diagnostic performance. Careful consideration and additional manual adjustment are needed for dental measurements regarding tooth structures for higher accuracy and better performance.

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Laparoscopic augmented reality registration for oncological resection site repair

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-021-02336-x ◽

2021 ◽

Author(s):

Fabian Joeres ◽

Tonia Mielke ◽

Christian Hansen

Keyword(s):

Augmented Reality ◽

Time Pressure ◽

Tumour Resection ◽

Anatomical Landmarks ◽

Proof Of Concept ◽

Registration Accuracy ◽

Target Registration Error ◽

Concept Evaluation ◽

Navigation Support ◽

Challenges And Opportunities

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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