Workflow and simulation of image-to-physical registration of holes inside spongy bone
Workflow and simulation of image-to-physical registration of holes inside spongy bone
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DOI：
10.1007/s11548-017-1594-5
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发表时间：
2017-08-01
影响因子：
3
通讯作者：
Kahrs，Lueder A.
中科院分区：
文献类型：
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作者：
Bergmeier，Jan;Fitzpatrick，J. Michael;Kahrs，Lueder A.
目的类乳细胞和骨小梁提供独特的骨结构，可作为注册的自然标志。术前成像可以充分获取这些结构，但注册需要术中对应物。由于各种外科手术包括钻入乳突细胞和小梁，我们提出了一种基于内窥镜在这些钻孔内的配准方法。方法记录内钻孔的表面产生提供术中配准特征的骨-空气图案。在这篇文章中，我们讨论了一种将钻孔表面展开为二维图像的方法。将术中内窥镜记录与模拟内窥镜切面进行比较，模拟内窥镜切面来自术前数据，如计算机断层扫描。每个模拟视图对应不同的钻探姿势。使用高分辨率图像数据模拟手术前图像数据和内窥镜图像数据，演示了整个配准过程和工作流程。结果由于驱动应用是目标靠近钻孔轴线的微创人工耳蜗术，测量了目标配准误差(TrE)在轴线附近的点。随着更多的骨骼-空气模式成为地标，在中心点获得最高精度，沿着钻探轨迹增加深度的TRE显示出越来越高的配准精度。在面窝和耳蜗处，tre分别为1 mm和1 mm。结论本研究提出了一种新的配准方法，通过在内窥镜下获取小梁或乳突细胞等小特征进行图像引导手术。它具有彻底改变骨注册的潜力，因为它只需要术前数据集和术中内窥镜探查。建议使用长度至少为20 mm的内窥镜记录，以及术前图像数据的各向同性体素大小为0.2 mm或更小。
PurposeMastoid cells as well as trabecula provide unique bone structures, which can serve as natural landmarks for registration. Preoperative imaging enables sufficient acquisition of these structures, but registration requires an intraoperative counterpart. Since versatile surgical interventions involve drilling into mastoid cells and trabecula, we propose a registration method based on endoscopy inside of these drill holes.MethodsRecording of the surface of the inner drill hole yields bone-air patterns that provide intraoperative registration features. In this contribution, we discuss an approach that unrolls the drill hole surface into a two-dimensional image. Intraoperative endoscopic recordings are compared to simulated endoscopic views, which originate from preoperative data like computed tomography. Each simulated view corresponds to a different drill pose. The whole registration procedure and workflow is demonstrated, using high-resolution image data to simulate both preoperative and endoscopic image data.ResultsAs the driving application is minimally invasive cochlear implantation, in which targets are close to the axis of the drill hole, Target Registration Error (TRE) was measured at points near the axis. TRE at increasing depths along the drill trajectory reveals increasing registration accuracy as more bone-air patterns become available as landmarks with the highest accuracy obtained at the center point. At the facial recess and the cochlea, TREs are () mm and () mm, respectively.ConclusionThis contribution demonstrates a new method for registration via endoscopic acquisition of small features like trabecula or mastoid cells for image-guided procedures. It has the potential to revolutionize bone registration because it requires only a preoperative dataset and intraoperative endoscopic exploration. Endoscopic recordings of at least 20 mm length and isotropic voxel sizes of 0.2 mm or smaller of the preoperative image data are recommended.