Improved Surgical Navigation Using Video-CT Registration

摘要 在许多外科手术中，图像引导外科手术（IGS）（也称为外科手术导航）有助于 在大脑和眼睛等关键结构附近进行精确的手术操作。IGS遭受严重的 局限性，如手术开始后精度和与术前成像的一致性丧失， 解剖结构发生了改变这些局限性可以通过术中成像来解决， “重置”模型，从而提高IGS的精度并改善手术决策- 制作。然而，术中放射成像有许多局限性，包括工作流程的中断， 成本和额外的辐射暴露。该项目旨在开发解决IGS局限性的解决方案 而不需要术中放射成像。我们的解决方案依赖于来自设备的数据， 存在于使用IGS的每个程序中，即内窥镜。我们在这个项目中的目标是使用内窥镜视频 图像来重建手术解剖结构的变化。这使得能够持续精确地配准预- 通过随着手术进展更新解剖模型，在整个手术过程中进行手术成像。我们将 实现这一目标的方法是：1）利用计算机视觉的进步，开发连续直接测量的改进方法。 内窥镜和CT之间的配准;以及2）开发连续计算 观察到的表面的几何形状，并更新术前CT与几何形状的变化。技术 因此，在该建议中开发的内窥镜能够实现以下：1）使用内窥镜的精确外科手术导航 2）无需额外的术中成像即可做出手术决策; （3）重建手术解剖和定量评价手术范围的新工具。

Abstract In many surgical procedures, image guided surgery (IGS), also known as surgical navigation, facilitates precise surgical manipulations near critical structures such as the brain and eye. IGS suffers from critical limitations such as loss of precision and correspondence with preoperative imaging once surgery begins and the anatomy is altered. These limitations may be addressed through intra-operative imaging, which effectively “resets” the model and thus enables both improved precision of IGS as well as improved surgical decision- making. However, intraoperative radiologic imaging has many limitations, including disruption of the workflow, cost, and additional radiation exposure. This project aims to develop solutions to resolve limitations of IGS without the need for intra-operative radiologic imaging. Our solutions rely upon data from a device that is present in every procedure using IGS, namely, the endoscope. Our goal in this project is use endoscopic video images to reconstruct surgical anatomy as it changes. This enables sustained precision in registration with pre- operative imaging throughout the procedure by updating the anatomical model as surgery progresses. We will achieve this by 1) using advances in computer vision to develop improved methods for continuous direct registration between the endoscope and the CT; and 2) developing methods that continuously compute the geometry of observed surfaces and update the preoperative CT with changes in that geometry. The technology developed in this proposal thus enables the following: 1) precise surgical navigation using the endoscope throughout the procedure; 2) surgical decision-making without the need for additional intra-operative imaging; and 3) new tools to reconstruct surgical anatomy and quantitatively evaluate the extent of surgery.