Pivot calibration concept for sensor attached mobile c-arms

Medical augmented reality has been actively studied for decades and many methods have been proposed torevolutionize clinical procedures. One example is the camera augmented mobile C-arm (CAMC), which providesa real-time video augmentation onto medical images by rigidly mounting and calibrating a camera to the imagingdevice. Since then, several CAMC variations have been suggested by calibrating 2D/3D cameras, trackers, andmore recently a Microsoft HoloLens to the C-arm. Different calibration methods have been applied to establishthe correspondence between the rigidly attached sensor and the imaging device. A crucial step for these methodsis the acquisition of X-Ray images or 3D reconstruction volumes; therefore, requiring the emission of ionizingradiation. In this work, we analyze the mechanical motion of the device and propose an alternatative methodto calibrate sensors to the C-arm without emitting any radiation. Given a sensor is rigidly attached to thedevice, we introduce an extended pivot calibration concept to compute the fixed translation from the sensor tothe C-arm rotation center. The fixed relationship between the sensor and rotation center can be formulated as apivot calibration problem with the pivot point moving on a locus. Our method exploits the rigid C-arm motiondescribing a Torus surface to solve this calibration problem. We explain the geometry of the C-arm motion andits relation to the attached sensor, propose a calibration algorithm and show its robustness against noise, as wellas trajectory and observed pose density by computer simulations. We discuss this geometric-based formulationand its potential extensions to different C-arm applications.Comment: Accepted for Image-Guided Procedures, Robotic Interventions, and Modeling 2020, Houston, TX, US

Virtual Reality Aided Mobile C-arm Positioning for Image-Guided Surgery

Image-guided surgery (IGS) is the minimally invasive procedure based on the pre-operative volume in conjunction with intra-operative X-ray images which are commonly captured by mobile C-arms for the confirmation of surgical outcomes. Although currently some commercial navigation systems are employed, one critical issue of such systems is the neglect regarding the radiation exposure to the patient and surgeons. In practice, when one surgical stage is finished, several X-ray images have to be acquired repeatedly by the mobile C-arm to obtain the desired image. Excessive radiation exposure may increase the risk of some complications. Therefore, it is necessary to develop a positioning system for mobile C-arms, and achieve one-time imaging to avoid the additional radiation exposure. In this dissertation, a mobile C-arm positioning system is proposed with the aid of virtual reality (VR). The surface model of patient is reconstructed by a camera mounted on the mobile C-arm. A novel registration method is proposed to align this model and pre-operative volume based on a tracker, so that surgeons can visualize the hidden anatomy directly from the outside view and determine a reference pose of C-arm. Considering the congested operating room, the C-arm is modeled as manipulator with a movable base to maneuver the image intensifier to the desired pose. In the registration procedure above, intensity-based 2D/3D registration is used to transform the pre-operative volume into the coordinate system of tracker. Although it provides a high accuracy, the small capture range hinders its clinical use due to the initial guess. To address such problem, a robust and fast initialization method is proposed based on the automatic tracking based initialization and multi-resolution estimation in frequency domain. This hardware-software integrated approach provides almost optimal transformation parameters for intensity-based registration. To determine the pose of mobile C-arm, high-quality visualization is necessary to locate the pathology in the hidden anatomy. A novel dimensionality reduction method based on sparse representation is proposed for the design of multi-dimensional transfer function in direct volume rendering. It not only achieves the similar performance to the conventional methods, but also owns the capability to deal with the large data sets

AUGMENTED REALITY AND INTRAOPERATIVE C-ARM CONE-BEAM COMPUTED TOMOGRAPHY FOR IMAGE-GUIDED ROBOTIC SURGERY

Minimally-invasive robotic-assisted surgery is a rapidly-growing alternative to traditionally open and laparoscopic procedures; nevertheless, challenges remain. Standard of care derives surgical strategies from preoperative volumetric data (i.e., computed tomography (CT) and magnetic resonance (MR) images) that benefit from the ability of multiple modalities to delineate different anatomical boundaries. However, preoperative images may not reflect a possibly highly deformed perioperative setup or intraoperative deformation. Additionally, in current clinical practice, the correspondence of preoperative plans to the surgical scene is conducted as a mental exercise; thus, the accuracy of this practice is highly dependent on the surgeon’s experience and therefore subject to inconsistencies. In order to address these fundamental limitations in minimally-invasive robotic surgery, this dissertation combines a high-end robotic C-arm imaging system and a modern robotic surgical platform as an integrated intraoperative image-guided system. We performed deformable registration of preoperative plans to a perioperative cone-beam computed tomography (CBCT), acquired after the patient is positioned for intervention. From the registered surgical plans, we overlaid critical information onto the primary intraoperative visual source, the robotic endoscope, by using augmented reality. Guidance afforded by this system not only uses augmented reality to fuse virtual medical information, but also provides tool localization and other dynamic intraoperative updated behavior in order to present enhanced depth feedback and information to the surgeon. These techniques in guided robotic surgery required a streamlined approach to creating intuitive and effective human-machine interferences, especially in visualization. Our software design principles create an inherently information-driven modular architecture incorporating robotics and intraoperative imaging through augmented reality. The system's performance is evaluated using phantoms and preclinical in-vivo experiments for multiple applications, including transoral robotic surgery, robot-assisted thoracic interventions, and cocheostomy for cochlear implantation. The resulting functionality, proposed architecture, and implemented methodologies can be further generalized to other C-arm-based image guidance for additional extensions in robotic surgery