Live augmented reality: a new visualization method for laparoscopic surgery using continuous volumetric computed tomography
Live augmented reality: a new visualization method for laparoscopic surgery using continuous volumetric computed tomography
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DOI：
10.1007/s00464-010-0890-8
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发表时间：
2010-08-01
影响因子：
3.1
通讯作者：
Park, Adrian
中科院分区：
文献类型：
--
作者：
Shekhar, Raj;Dandekar, Omkar;Park, Adrian
目前的腹腔镜图像表面细节丰富，但缺乏更深层次的结构信息。本报告提出了一种新的方法，突出这些结构在腹腔镜手术中使用连续多层计算机断层扫描（CT）。这导致了一种更准确的增强现实（AR）方法，称为“实时AR”，它将来自实时低剂量术中CT的三维（3D）解剖结构与来自腹腔镜的实时图像融合在一起。在CT室进行了一系列猪手术，该CT室配有设备齐全的腹腔镜手术室。使用64层CT扫描仪对术野进行成像，大约每秒一次。手术开始于肝脏的对比增强诊断质量CT扫描（初始CT），随后是连续术中CT和光学跟踪腹腔镜腹腔镜成像。术中解剖结构变化包括用户施加的变形和呼吸引起的变形。通过可变形图像配准（一个中间图像处理步骤），初始CT被扭曲以在空间上与低剂量术中CT扫描对齐。配准的初始CT然后被渲染并与腹腔镜图像合并以创建实时AR。使用所描述的方法对软组织变形的上级补偿导致腹腔镜图像与渲染的CT图像之间的空间配准比传统AR更精确。此外，用配准的初始CT代替低剂量CT有助于血管系统的连续可视化，并提供术中X射线剂量至少减少八倍的潜力。作者提出并开发了实时AR，这是一种新的手术可视化方法，将腹腔镜的丰富表面细节与手术野连续CT扫描的即时3D解剖结构相结合。通过创新性地使用可变形图像配准，他们还证明了血管系统连续可视化的可行性和相当大的X射线剂量降低。该研究为进一步研究和开发活体AR提供了动力。
Current laparoscopic images are rich in surface detail but lack information on deeper structures. This report presents a novel method for highlighting these structures during laparoscopic surgery using continuous multislice computed tomography (CT). This has resulted in a more accurate augmented reality (AR) approach, termed "live AR," which merges three-dimensional (3D) anatomy from live low-dose intraoperative CT with live images from the laparoscope.A series of procedures with swine was conducted in a CT room with a fully equipped laparoscopic surgical suite. A 64-slice CT scanner was used to image the surgical field approximately once per second. The procedures began with a contrast-enhanced, diagnostic-quality CT scan (initial CT) of the liver followed by continuous intraoperative CT and laparoscopic imaging with an optically tracked laparoscope. Intraoperative anatomic changes included user-applied deformations and those from breathing. Through deformable image registration, an intermediate image processing step, the initial CT was warped to align spatially with the low-dose intraoperative CT scans. The registered initial CT then was rendered and merged with laparoscopic images to create live AR.Superior compensation for soft tissue deformations using the described method led to more accurate spatial registration between laparoscopic and rendered CT images with live AR than with conventional AR. Moreover, substitution of low-dose CT with registered initial CT helped with continuous visualization of the vasculature and offered the potential of at least an eightfold reduction in intraoperative X-ray dose.The authors proposed and developed live AR, a new surgical visualization approach that merges rich surface detail from a laparoscope with instantaneous 3D anatomy from continuous CT scanning of the surgical field. Through innovative use of deformable image registration, they also demonstrated the feasibility of continuous visualization of the vasculature and considerable X-ray dose reduction. This study provides motivation for further investigation and development of live AR.