2,448 research outputs found
Computer-assisted access to the kidney
OBJECTIVES: The aim of this paper is to introduce the principles of
computer-assisted access to the kidney. The system provides the surgeon with a
pre-operative 3D planning on computed tomography (CT) images. After a rigid
registration with space-localized ultrasound (US) data, preoperative planning
can be transferred to the intra-operative conditions and an intuitive
man-machine interface allows the user to perform a puncture. MATERIAL AND
METHODS: Both CT and US images of informed normal volunteer were obtained to
perform calculation on the accuracy of registration and punctures were carried
out on a kidney phantom to measure the precision of the whole of the system.
RESULTS: We carried out millimetric registrations on real data and guidance
experiments on a kidney phantom showed encouraging results of 4.7 mm between
planned and reached targets. We noticed that the most significant error was
related to the needle deflection during the puncture. CONCLUSION: Preliminary
results are encouraging. Further work will be undertaken to improve efficiency
and accuracy, and to take breathing into account
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
Prosper: image and robot-guided prostate brachytherapy
Brachytherapy for localized prostate cancer consists in destroying cancer by
introducing iodine radioactive seeds into the gland through hollow needles. The
planning of the position of the seeds and their introduction into the prostate
is based on intra-operative ultrasound (US) imaging. We propose to optimize the
global quality of the procedure by: i) using 3D US; ii) enhancing US data with
MRI registration; iii) using a specially designed needle-insertion robot,
connected to the imaging data. The imaging methods have been successfully
tested on patient data while the robot accuracy has been evaluated on a
realistic deformable phantom
Autonomous Tissue Scanning under Free-Form Motion for Intraoperative Tissue Characterisation
In Minimally Invasive Surgery (MIS), tissue scanning with imaging probes is
required for subsurface visualisation to characterise the state of the tissue.
However, scanning of large tissue surfaces in the presence of deformation is a
challenging task for the surgeon. Recently, robot-assisted local tissue
scanning has been investigated for motion stabilisation of imaging probes to
facilitate the capturing of good quality images and reduce the surgeon's
cognitive load. Nonetheless, these approaches require the tissue surface to be
static or deform with periodic motion. To eliminate these assumptions, we
propose a visual servoing framework for autonomous tissue scanning, able to
deal with free-form tissue deformation. The 3D structure of the surgical scene
is recovered and a feature-based method is proposed to estimate the motion of
the tissue in real-time. A desired scanning trajectory is manually defined on a
reference frame and continuously updated using projective geometry to follow
the tissue motion and control the movement of the robotic arm. The advantage of
the proposed method is that it does not require the learning of the tissue
motion prior to scanning and can deal with free-form deformation. We deployed
this framework on the da Vinci surgical robot using the da Vinci Research Kit
(dVRK) for Ultrasound tissue scanning. Since the framework does not rely on
information from the Ultrasound data, it can be easily extended to other
probe-based imaging modalities.Comment: 7 pages, 5 figures, ICRA 202
Prostate biopsies guided by three-dimensional real-time (4-D) transrectal ultrasonography on a phantom: comparative study versus two-dimensional transrectal ultrasound-guided biopsies
OBJECTIVE: This study evaluated the accuracy in localisation and distribution
of real-time three-dimensional (4-D) ultrasound-guided biopsies on a prostate
phantom. METHODS: A prostate phantom was created. A three-dimensional real-time
ultrasound system with a 5.9MHz probe was used, making it possible to see
several reconstructed orthogonal viewing planes in real time. Fourteen
operators performed biopsies first under 2-D then 4-D transurethral ultrasound
(TRUS) guidance (336 biopsies). The biopsy path was modelled using segmentation
in a 3-D ultrasonographic volume. Special software was used to visualise the
biopsy paths in a reference prostate and assess the sampled area. A comparative
study was performed to examine the accuracy of the entry points and target of
the needle. Distribution was assessed by measuring the volume sampled and a
redundancy ratio of the sampled prostate. RESULTS: A significant increase in
accuracy in hitting the target zone was identified using 4-D ultrasonography as
compared to 2-D. There was no increase in the sampled volume or improvement in
the biopsy distribution with 4-D ultrasonography as compared to 2-D.
CONCLUSION: The 4-D TRUS guidance appears to show, on a synthetic model, an
improvement in location accuracy and in the ability to reproduce a protocol.
The biopsy distribution does not seem improved
Biopsym : a learning environment for transrectal ultrasound guided prostate biopsies
This paper describes a learning environment for image-guided prostate
biopsies in cancer diagnosis; it is based on an ultrasound probe simulator
virtually exploring real datasets obtained from patients. The aim is to make
the training of young physicians easier and faster with a tool that combines
lectures, biopsy simulations and recommended exercises to master this medical
gesture. It will particularly help acquiring the three-dimensional
representation of the prostate needed for practicing biopsy sequences. The
simulator uses a haptic feedback to compute the position of the virtual probe
from three-dimensional (3D) ultrasound recorded data. This paper presents the
current version of this learning environment
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