Atlas and feature based 3D pathway visualization enhancement for skull base pre-operative fast planning from head CT.
Atlas and feature based 3D pathway visualization enhancement for skull base pre-operative fast planning from head CT.
复制标题
基于图集和特征的 3D 路径可视化增强，可通过头部 CT 进行颅底术前快速规划。
DOI：
10.1117/12.2081649
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Hannaford,Blake
中科院分区：
文献类型：
--
作者：
Aghdasi,Nava;Li,Yangming;Berens,Angelique;Moe,KrisS;Bly,RandallA;Hannaford,Blake
微创神经内窥镜手术为许多颅底病变提供了开颅手术的替代方案。这些技术通过缩短 ICU 停留时间、减少术后疼痛和更快恢复基线功能为患者带来巨大益处。然而，颅底关键神经血管结构的密度使得这些手术的规划变得非常复杂。此外，通常使用额外的手术入口来改善可视化和器械访问，这增加了术前计划的复杂性。目前，手术入路规划有限，通常涉及查看 2D 轴向、冠状和矢状 CT 和 MRI 图像。此外，颅底外科医生手动改变可视化效果，以审查到达目标病变的所有可能方法并实现最佳手术计划。这个繁琐的过程很大程度上依赖于外科医生的经验，并且不允许 3D 可视化。在本文中，我们使用以下两个新概念描述了颅底手术的快速术前计划系统：基于重要性的突出显示和移动门户。通过这项创新，3D CT 模型中的关键区域将根据分割结果突出显示。移动门户允许外科医生实时检查多个潜在的进入门户，并改进位于路径内的关键结构的可视化。为了实现这一目标，我们使用了以下方法：（1）手动生成新颖的纯骨图集，（2）轨道和颅骨中心作为特征，将患者的扫描与图集快速预对准，（3）使用可变形配准技术进行精细对准，（4）根据手术词典为每个体素分配手术重要性，（5）应用预定义的传递函数 处理后的数据以突出显示重要的结构。所提出的想法已作为独立规划软件得到全面实施，并使用附加数据进行验证和确认。实验结果表明：（1）所提出的方法大大提高了规划效率，同时成功实现了最佳手术计划；（2）所提出的方法成功突出了重要结构并促进了规划；（3）所提出的方法比经典分割算法需要更短的处理时间；（4）这些方法可用于提高手术机器人的手术安全性。
Minimally invasive neuroendoscopic surgery provides an alternative to open craniotomy for many skull base lesions. These techniques provides a great benefit to the patient through shorter ICU stays, decreased post-operative pain and quicker return to baseline function. However, density of critical neurovascular structures at the skull base makes planning for these procedures highly complex. Furthermore, additional surgical portals are often used to improve visualization and instrument access, which adds to the complexity of pre-operative planning. Surgical approach planning is currently limited and typically involves review of 2D axial, coronal, and sagittal CT and MRI images. In addition, skull base surgeons manually change the visualization effect to review all possible approaches to the target lesion and achieve an optimal surgical plan. This cumbersome process relies heavily on surgeon experience and it does not allow for 3D visualization. In this paper, we describe a rapid pre-operative planning system for skull base surgery using the following two novel concepts:importance-based highlightandmobile portal. With this innovation, critical areas in the 3D CT model are highlighted based on segmentation results. Mobile portals allow surgeons to review multiple potential entry portals in real-time with improved visualization of critical structures located inside the pathway. To achieve this we used the following methods: (1) novel bone-only atlases were manually generated, (2) orbits and the center of the skull serve as features to quickly pre-align the patient’s scan with the atlas, (3) deformable registration technique was used for fine alignment, (4) surgical importance was assigned to each voxel according to a surgical dictionary, and (5) pre-defined transfer function was applied to the processed data to highlight important structures. The proposed idea was fully implemented as independent planning software and additional data are used for verification and validation. The experimental results show: (1) the proposed methods provided greatly improved planning efficiency while optimal surgical plans were successfully achieved, (2) the proposed methods successfully highlighted important structures and facilitated planning, (3) the proposed methods require shorter processing time than classical segmentation algorithms, and (4) these methods can be used to improve surgical safety for surgical robots.