Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery.
Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery.
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DOI：
10.1109/tbme.2015.2415731
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发表时间：
2015-09
期刊：
影响因子：
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通讯作者：
Lollis SS
中科院分区：
文献类型：
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作者：
Ji S;Fan X;Paulsen KD;Roberts DW;Mirza SK;Lollis SS
尽管图像引导技术在开放颅神经外科手术中广泛应用并取得了成功，但在开放脊柱手术中的应用仍然受到限制，这在很大程度上是因为患者登记方面的挑战。在这项研究中，我们评估了在开放脊柱融合手术中使用术中立体视觉（iSV）进行准确、高效和稳健的患者登记的可行性。首先从iSV重建暴露椎体的几何表面。然后在iSV和术前脊柱CT （pCT）图像产生的点云之间执行经典的多起点配准。通过手动识别两对特征点以方便配准，使用单个iSV图像对采样2-3个椎节，8例患者的平均配准精度为1.43 mm。iSV配准误差始终小于传统的地标方法（在相同误差度量下平均为2.02 mm）。在iSV患者登记中发现的大捕获范围（平均平移23.8 mm和旋转46.0度）表明该技术可以为手术室的实际应用提供足够的稳健性。虽然仍然需要一些手工工作，但iSV注册的手工输入只需要近似，而不是精确和准确地用于地标注册所需的手工工作。iSV注册的总计算成本平均为1.5分钟，明显低于典型的地标方法所需的~30分钟。这些发现支持了iSV在开放脊柱手术中提供准确、高效和稳健的患者登记的临床可行性，因此，它有可能进一步增加该外科专业对图像引导的采用。
Despite its widespread availability and success in open cranial neurosurgery, image-guidance technology remains more limited in use in open spinal procedures, in large part because of patient registration challenges. In this study, we evaluated the feasibility of using intraoperative stereovision (iSV) for accurate, efficient and robust patient registration in open spinal fusion surgery. Geometrical surfaces of exposed vertebrae were first reconstructed from iSV. A classical multi-start registration was then executed between point clouds generated from iSV and preoperative CT (pCT) images of the spine. With two pairs of feature points manually identified to facilitate the registration, an average registration accuracy of 1.43 mm in terms of surface-to-surface distance error was achieved in 8 patient cases using a single iSV image pair sampling 2–3 vertebral segments. The iSV registration error was consistently smaller than the conventional landmark approach for every case (average of 2.02 mm with the same error metric). The large capture ranges (average of 23.8 mm in translation and 46.0 deg in rotation) found in the iSV patient registration suggest the technique may offer sufficient robustness for practical application in the operating room. Although some manual effort was still necessary, the manually-derived inputs for iSV registration only needed to be approximate as opposed to be precise and accurate for the manual efforts required in landmark registration. The total computational cost of the iSV registration was 1.5 min on average, significantly less than the typical ~30 min required for the landmark approach. These findings support the clinical feasibility of iSV to offer accurate, efficient and robust patient registration in open spinal surgery, and therefore, its potential to further increase the adoption of image-guidance in this surgical specialty.