An incremental registration method for endoscopic sinus and skull base surgery navigation: From phantom study to clinical trials
An incremental registration method for endoscopic sinus and skull base surgery navigation: From phantom study to clinical trials
复制标题
内窥镜鼻窦和颅底手术导航的增量配准方法：从模型研究到临床试验
DOI：
10.1002/mp.15941
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发表时间：
2022-08-31
期刊：
影响因子：
3.8
通讯作者：
Yang，Jian
中科院分区：
文献类型：
--
作者：
Li，Wenjie;Fan，Jingfan;Yang，Jian
目前手术导航中基于表面的图像对患者配准主要是通过3D扫描仪实现的，但在临床实践中存在扫描范围不可控、操作复杂、失败率高等局限性。迫切需要一种准确，稳健，易于执行的图像到患者注册方法。方法采用增量点云配准方法进行基于表面的图像对患者配准。从计算机断层扫描（CT）图像中提取图像空间中的点云，采用模板匹配法去除冗余点。采用光迹指针增量采集患者空间中相应的点云，同时采用最近点距离（nearest point distance， NPD）约束，保证采集点的均匀性。然后提出了一种基于覆盖率（CR）和离群值（OR）约束的粗-细配准方法，以获得从图像到患者空间的最优刚性变换。将所提出的方法集成到最近开发的内镜导航系统中，并进行了幻影研究和临床试验来评估所提出方法的性能。结果幻影实验结果表明，所提出的约束条件大大提高了配准的准确性和鲁棒性。对比实验结果表明，所提出的配准方法明显优于基于扫描仪的配准方法，其精度与基于基准的配准方法相当。在临床试验中，平均注册时间为1.24±0.43 min， 294个标记点（59例）的目标注册误差（TRE）为1.25±0.40 mm，定位标记点成功率的97.5%下限超过期望值（97.56% vs. 95.00%），表明所提出方法的准确性显著满足临床要求（TRE≤2 mm,p< 0.05）。结论该方法具有扫描法和基准法所缺乏的精度高、操作方便等优点。我们的发现将有助于提高内镜鼻窦和颅底手术的质量。
PurposeSurface‐based image‐to‐patient registration in current surgical navigation is mainly achieved by a 3D scanner, which has several limitations in clinical practice such as uncontrollable scanning range, complicated operation, and even high failure rate. An accurate, robust, and easy‐to‐perform image‐to‐patient registration method is urgently required.MethodsAn incremental point cloud registration method was proposed for surface‐based image‐to‐patient registration. The point cloud in image space was extracted from the computed tomography (CT) image, and a template matching method was applied to remove the redundant points. The corresponding point cloud in patient space was incrementally collected by an optically tracked pointer, while the nearest point distance (NPD) constraint was applied to ensure the uniformity of the collected points. A coarse‐to‐fine registration method under the constraints of coverage ratio (CR) and outliers ratio (OR) was then proposed to obtain the optimal rigid transformation from image to patient space. The proposed method was integrated in the recently developed endoscopic navigation system, and phantom study and clinical trials were conducted to evaluate the performance of the proposed method.ResultsThe results of the phantom study revealed that the proposed constraints greatly improved the accuracy and robustness of registration. The comparative experimental results revealed that the proposed registration method significantly outperform the scanner‐based method, and achieved comparable accuracy to the fiducial‐based method. In the clinical trials, the average registration duration was 1.24 ± 0.43 min, the target registration error (TRE) of 294 marker points (59 patients) was 1.25 ± 0.40 mm, and the lower 97.5% confidence limit of the success rate of positioning marker points exceeds the expected value (97.56% vs. 95.00%), revealed that the accuracy of the proposed method significantly met the clinical requirements (TRE ⩽ 2 mm,p< 0.05).ConclusionsThe proposed method has both the advantages of high accuracy and convenience, which were absent in the scanner‐based method and the fiducial‐based method. Our findings will help improve the quality of endoscopic sinus and skull base surgery.