Microscope Embedded Neurosurgical Training and Intraoperative System

In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients\u27 safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon\u27s experience. In this frame, medical training is particularly important. From a technological point of view, the use of Virtual Reality (VR) for surgeon training and Augmented Reality (AR) for intra-operative treatments offer the best results. In addition, traditional techniques for training in surgery include the use of animals, phantoms and cadavers. The main limitation of these approaches is that live tissue has different properties from dead tissue and that animal anatomy is significantly different from the human. From the medical point of view, Low-Grade Gliomas (LGGs) are intrinsic brain tumours that typically occur in younger adults. The objective of related treatment is to remove as much of the tumour as possible while minimizing damage to the healthy brain. Pathological tissue may closely resemble normal brain parenchyma when looked at through the neurosurgical microscope. The tactile appreciation of the different consistency of the tumour compared to normal brain requires considerable experience on the part of the neurosurgeon and it is a vital point. The first part of this PhD thesis presents a system for realistic simulation (visual and haptic) of the spatula palpation of the LGG. This is the first prototype of a training system using VR, haptics and a real microscope for neurosurgery. This architecture can be also adapted for intra-operative purposes. In this instance, a surgeon needs the basic setup for the Image Guided Therapy (IGT) interventions: microscope, monitors and navigated surgical instruments. The same virtual environment can be AR rendered onto the microscope optics. The objective is to enhance the surgeon\u27s ability for a better intra-operative orientation by giving him a three-dimensional view and other information necessary for a safe navigation inside the patient. The last considerations have served as motivation for the second part of this work which has been devoted to improving a prototype of an AR stereoscopic microscope for neurosurgical interventions, developed in our institute in a previous work. A completely new software has been developed in order to reuse the microscope hardware, enhancing both rendering performances and usability. Since both AR and VR share the same platform, the system can be referred to as Mixed Reality System for neurosurgery. All the components are open source or at least based on a GPL license

Towards Real-time Remote Processing of Laparoscopic Video

Laparoscopic surgery is a minimally invasive technique where surgeons insert a small video camera into the patient\u27s body to visualize internal organs and use small tools to perform these procedures. However, the benefit of small incisions has a disadvantage of limited visualization of subsurface tissues. Image-guided surgery (IGS) uses pre-operative and intra-operative images to map subsurface structures and can reduce the limitations of laparoscopic surgery. One particular laparoscopic system is the daVinci-si robotic surgical vision system. The video streams generate approximately 360 megabytes of data per second, demonstrating a trend toward increased data sizes in medicine, primarily due to higher-resolution video cameras and imaging equipment. Real-time processing this large stream of data on a bedside PC, single or dual node setup, may be challenging and a high-performance computing (HPC) environment is not typically available at the point of care. To process this data on remote HPC clusters at the typical 30 frames per second rate (fps), it is required that each 11.9 MB (1080p) video frame be processed by a server and returned within the time this frame is displayed or 1/30th of a second. The ability to acquire, process, and visualize data in real time is essential for the performance of complex tasks as well as minimizing risk to the patient. We have implemented and compared performance of compression, segmentation and registration algorithms on Clemson\u27s Palmetto supercomputer using dual Nvidia graphics processing units (GPUs) per node and compute unified device architecture (CUDA) programming model. We developed three separate applications that run simultaneously: video acquisition, image processing, and video display. The image processing application allows several algorithms to run simultaneously on different cluster nodes and transfer images through message passing interface (MPI). Our segmentation and registration algorithms resulted in an acceleration factor of around 2 and 8 times respectively. To achieve a higher frame rate, we also resized images and reduced the overall processing time. As a result, using high-speed network to access computing clusters with GPUs to implement these algorithms in parallel will improve surgical procedures by providing real-time medical image processing and laparoscopic data

ConoSurf: Open-source 3D scanning system based on a conoscopic holography device for acquiring surgical surfaces

Background. A difficulty in computer-assisted interventions is acquiring the patient's anatomy intraoperatively. Standard modalities have several limitations: low image quality (ultrasound), radiation exposure (computed tomography) or high costs (magnetic resonance imaging). An alternative approach uses a tracked pointer; however, the pointer causes tissue deformation and requires sterilizing. Recent proposals, utilizing a tracked conoscopic holography device, have shown promising results without the previously mentioned drawbacks. Methods. We have developed an open-source software system that enables real-time surface scanning using a conoscopic holography device and a wide variety of tracking systems, integrated into pre-existing and well-supported software solutions. Results. The mean target registration error of point measurements was 1.46 mm. For a quick guidance scan, surface reconstruction improved the surface registration error compared with point-set registration. Conclusions. We have presented a system enabling real-time surface scanning using a tracked conoscopic holography device. Results show that it can be useful for acquiring the patient's anatomy during surgery.Funding information: (Comunidad de Madrid), Grant/Award Number: TOPUS‐CM S2013/MIT‐3024; (Ministerio de Economía y Competitividad, ISCIII), Grant/Award Number: PI15/02121. DTS14/00192. TEC2013–48251‐C2–1‐R, FEDER fund

Image-guided neurosurgery : integration of medical image data with real-time view of the surgical field

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 1997.Includes bibliographical references (leaf 50).by Michael J. Timmons.M.S

Accelerating 3D Non-Rigid Registration using Graphics Hardware

International audienceThere is an increasing need for real-time implementation of 3D image analysis processes, especially in the context of image-guided surgery. Among the various image analysis tasks, non-rigid image registration is particularly needed and is also computationally prohibitive. This paper presents a GPU (Graphical Processing Unit) implementation of the popular Demons algorithm using a Gaussian recursive filtering. Acceleration of the classical method is mainly achieved by a new filtering scheme on GPU which could be reused in or extended to other applications and denotes a significant contribution to the GPU-based image processing domain. This implementation was able to perform a non-rigid registration of 3D MR volumes in less than one minute, which corresponds to an acceleration factor of 10 compared to the corresponding CPU implementation. This demonstrated the usefulness of such method in an intra-operative context

Advancements and Breakthroughs in Ultrasound Imaging

Ultrasonic imaging is a powerful diagnostic tool available to medical practitioners, engineers and researchers today. Due to the relative safety, and the non-invasive nature, ultrasonic imaging has become one of the most rapidly advancing technologies. These rapid advances are directly related to the parallel advancements in electronics, computing, and transducer technology together with sophisticated signal processing techniques. This book focuses on state of the art developments in ultrasonic imaging applications and underlying technologies presented by leading practitioners and researchers from many parts of the world

Augmented Reality

Augmented Reality (AR) is a natural development from virtual reality (VR), which was developed several decades earlier. AR complements VR in many ways. Due to the advantages of the user being able to see both the real and virtual objects simultaneously, AR is far more intuitive, but it's not completely detached from human factors and other restrictions. AR doesn't consume as much time and effort in the applications because it's not required to construct the entire virtual scene and the environment. In this book, several new and emerging application areas of AR are presented and divided into three sections. The first section contains applications in outdoor and mobile AR, such as construction, restoration, security and surveillance. The second section deals with AR in medical, biological, and human bodies. The third and final section contains a number of new and useful applications in daily living and learning