6,812 research outputs found
Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology
Until recently, Computer-Aided Medical Interventions (CAMI) and Medical
Robotics have focused on rigid and non deformable anatomical structures.
Nowadays, special attention is paid to soft tissues, raising complex issues due
to their mobility and deformation. Mini-invasive digestive surgery was probably
one of the first fields where soft tissues were handled through the development
of simulators, tracking of anatomical structures and specific assistance
robots. However, other clinical domains, for instance urology, are concerned.
Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU,
radiofrequency, or cryoablation), increasingly early detection of cancer, and
use of interventional and diagnostic imaging modalities, recently opened new
challenges to the urologist and scientists involved in CAMI. This resulted in
the last five years in a very significant increase of research and developments
of computer-aided urology systems. In this paper, we propose a description of
the main problems related to computer-aided diagnostic and therapy of soft
tissues and give a survey of the different types of assistance offered to the
urologist: robotization, image fusion, surgical navigation. Both research
projects and operational industrial systems are discussed
Accuracy of a magnetic resonance imagingâbased 3D printed stereotactic brain biopsy device in dogs
Background:
Brain biopsy of intracranial lesions is often necessary to determine specific therapy. The cost of the currently used stereotactic rigid frame and optical tracking systems for brain biopsy in dogs is often prohibitive or accuracy is not sufficient for all types of lesion.
Objectives:
To evaluate the application accuracy of an inexpensive magnetic resonance imagingâbased personalized, 3D printed brain biopsy device.
Animals:
Twentyâtwo dog heads from cadavers were separated into 2 groups according to body weight (20âkg).
Methods:
Experimental study. Two target points in each cadaver head were used (target point 1: caudate nucleus, target point 2: piriform lobe). Comparison between groups was performed using the independent Student'sât test or the nonparametric MannâWhitney U Test.
Results:
The total median target point deviation was 0.83âmm (range 0.09â2.76âmm). The separate median target point deviations for target points 1 and 2 in all dogs were 0.57âmm (range: 0.09â1.25âmm) and 0.85âmm (range: 0.14â2.76âmm), respectively.
Conclusion and Clinical Importance:
This magnetic resonance imagingâbased 3D printed stereotactic brain biopsy device achieved an application accuracy that was better than the accuracy of most brain biopsy systems that are currently used in veterinary medicine. The device can be applied to every size and shape of skull and allows precise positioning of brain biopsy needles in dogs
Imaging-guided chest biopsies: techniques and clinical results
Background
This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy.
Methods
Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive.
Results
Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy.
Conclusion
Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications
Prostate Biopsy Assistance System with Gland Deformation Estimation for Enhanced Precision
Computer-assisted prostate biopsies became a very active research area during
the last years. Prostate tracking makes it possi- ble to overcome several
drawbacks of the current standard transrectal ultrasound (TRUS) biopsy
procedure, namely the insufficient targeting accuracy which may lead to a
biopsy distribution of poor quality, the very approximate knowledge about the
actual location of the sampled tissues which makes it difficult to implement
focal therapy strategies based on biopsy results, and finally the difficulty to
precisely reach non-ultrasound (US) targets stemming from different modalities,
statistical atlases or previous biopsy series. The prostate tracking systems
presented so far are limited to rigid transformation tracking. However, the
gland can get considerably deformed during the intervention because of US probe
pres- sure and patient movements. We propose to use 3D US combined with
image-based elastic registration to estimate these deformations. A fast elastic
registration algorithm that copes with the frequently occurring US shadows is
presented. A patient cohort study was performed, which yielded a statistically
significant in-vivo accuracy of 0.83+-0.54mm.Comment: This version of the paper integrates a correction concerning the
local similarity measure w.r.t. the proceedings (this typing error could not
be corrected before editing the proceedings
Learning Deep Similarity Metric for 3D MR-TRUS Registration
Purpose: The fusion of transrectal ultrasound (TRUS) and magnetic resonance
(MR) images for guiding targeted prostate biopsy has significantly improved the
biopsy yield of aggressive cancers. A key component of MR-TRUS fusion is image
registration. However, it is very challenging to obtain a robust automatic
MR-TRUS registration due to the large appearance difference between the two
imaging modalities. The work presented in this paper aims to tackle this
problem by addressing two challenges: (i) the definition of a suitable
similarity metric and (ii) the determination of a suitable optimization
strategy.
Methods: This work proposes the use of a deep convolutional neural network to
learn a similarity metric for MR-TRUS registration. We also use a composite
optimization strategy that explores the solution space in order to search for a
suitable initialization for the second-order optimization of the learned
metric. Further, a multi-pass approach is used in order to smooth the metric
for optimization.
Results: The learned similarity metric outperforms the classical mutual
information and also the state-of-the-art MIND feature based methods. The
results indicate that the overall registration framework has a large capture
range. The proposed deep similarity metric based approach obtained a mean TRE
of 3.86mm (with an initial TRE of 16mm) for this challenging problem.
Conclusion: A similarity metric that is learned using a deep neural network
can be used to assess the quality of any given image registration and can be
used in conjunction with the aforementioned optimization framework to perform
automatic registration that is robust to poor initialization.Comment: To appear on IJCAR
Real-time virtual sonography in gynecology & obstetrics. literature's analysis and case series
Fusion Imaging is a latest generation diagnostic technique, designed to combine ultrasonography with a second-tier technique such as magnetic resonance imaging and computer tomography. It has been mainly used until now in urology and hepatology. Concerning gynecology and obstetrics, the studies mostly focus on the diagnosis of prenatal disease, benign pathology and cervical cancer. We provided a systematic review of the literature with the latest publications regarding the role of Fusion technology in gynecological and obstetrics fields and we also described a case series of six emblematic patients enrolled from Gynecology Department of Sant âAndrea Hospital, âla Sapienzaâ, Rome, evaluated with Esaote Virtual Navigator equipment. We consider that Fusion Imaging could add values at the diagnosis of various gynecological and obstetrics conditions, but further studies are needed to better define and improve the role of this fascinating diagnostic tool
BiopSym: a simulator for enhanced learning of ultrasound-guided prostate biopsy
This paper describes a simulator of ultrasound-guided prostate biopsies for
cancer diagnosis. When performing biopsy series, the clinician has to move the
ultrasound probe and to mentally integrate the real-time bi-dimensional images
into a three-dimensional (3D) representation of the anatomical environment.
Such a 3D representation is necessary to sample regularly the prostate in order
to maximize the probability of detecting a cancer if any. To make the training
of young physicians easier and faster we developed a simulator that combines
images computed from three-dimensional ultrasound recorded data to haptic
feedback. The paper presents the first version of this simulator
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