1,367 research outputs found
Method for coregistration of optical measurements of breast tissue with histopathology : the importance of accounting for tissue deformations
For the validation of optical diagnostic technologies, experimental results need to be benchmarked against the gold standard. Currently, the gold standard for tissue characterization is assessment of hematoxylin and eosin (H&E)-stained sections by a pathologist. When processing tissue into H&E sections, the shape of the tissue deforms with respect to the initial shape when it was optically measured. We demonstrate the importance of accounting for these tissue deformations when correlating optical measurement with routinely acquired histopathology. We propose a method to register the tissue in the H&E sections to the optical measurements, which corrects for these tissue deformations. We compare the registered H&E sections to H&E sections that were registered with an algorithm that does not account for tissue deformations by evaluating both the shape and the composition of the tissue and using microcomputer tomography data as an independent measure. The proposed method, which did account for tissue deformations, was more accurate than the method that did not account for tissue deformations. These results emphasize the need for a registration method that accounts for tissue deformations, such as the method presented in this study, which can aid in validating optical techniques for clinical use. (C) The Authors. Published by SPIE under a Creative Commons Attribution 4.0 Unported License
Multispectral image alignment using a three channel endoscope in vivo during minimally invasive surgery.
Sequential multispectral imaging is an acquisition technique that involves collecting images of a target at different wavelengths, to compile a spectrum for each pixel. In surgical applications it suffers from low illumination levels and motion artefacts. A three-channel rigid endoscope system has been developed that allows simultaneous recording of stereoscopic and multispectral images. Salient features on the tissue surface may be tracked during the acquisition in the stereo cameras and, using multiple camera triangulation techniques, this information used to align the multispectral images automatically even though the tissue or camera is moving. This paper describes a detailed validation of the set-up in a controlled experiment before presenting the first in vivo use of the device in a porcine minimally invasive surgical procedure. Multispectral images of the large bowel were acquired and used to extract the relative concentration of haemoglobin in the tissue despite motion due to breathing during the acquisition. Using the stereoscopic information it was also possible to overlay the multispectral information on the reconstructed 3D surface. This experiment demonstrates the ability of this system for measuring blood perfusion changes in the tissue during surgery and its potential use as a platform for other sequential imaging modalities
Dual-camera infrared guidance for computed tomography biopsy procedures
A CT-guided biopsy is a specialised surgical procedure whereby a needle is used to withdraw tissue or fluid specimen from a lesion of interest. The needle is guided while being viewed by a clinician on a computed tomography (CT) scan. CT guided biopsies invariably expose patients and operators to high dosage of radiation and are lengthy procedures where the lack of spatial referencing while guiding the needle along the required entry path
are some of the diffculties currently encountered. This research focuses on addressing two of the challenges clinicians currently face when performing CT-guided biopsy procedures.
The first challenge is the lack of spatial referencing during a biopsy procedure, with the requirement for improved accuracy and reduction in the number of repeated scans. In order to achieve this an infrared navigation system was designed and implemented where an existing approach was subsequently extended to help guide the clinician in advancing the biopsy needle. This extended algorithm computed a scaled estimate of the needle endpoint and assists with navigating the biopsy needle through a dedicated and custom built graphical user interface.
The second challenge was to design and implement a training environment where clinicians could practice different entry angles and scenarios. A prototype training module was designed and built to provide simulated biopsy procedures in order to help increase spatial referencing. Various experiments and different scenarios were designed and tested
to demonstrate the correctness of the algorithm and provide real-life simulated scenarios where the operators had a chance to practice different entry angles and familiarise themselves with the equipment. A comprehensive survey was also undertaken to investigate the advantages and disadvantages of the system
Advances in navigation and intraoperative imaging for intraoperative electron radiotherapy
Mención Internacional en el título de doctorEsta tesis se enmarca dentro del campo de la radioterapia y trata específicamente sobre
la radioterapia intraoperatoria (RIO) con electrones. Esta técnica combina la resección
quirúrgica de un tumor y la radiación terapéutica directamente aplicada sobre el lecho
tumoral post-resección o sobre el tumor no resecado. El haz de electrones de alta
energía es colimado y conducido por un aplicador específico acoplado a un acelerador
lineal. La planificación de la RIO con electrones es compleja debido a las
modificaciones geométricas y anatómicas producidas por la retracción de estructuras y
la eliminación de tejidos cancerosos durante la cirugía. Actualmente, no se dispone del
escenario real en este tipo de tratamientos (por ejemplo, la posición/orientación del
aplicador respecto a la anatomía del paciente o las irregularidades en la superficie
irradiada), sólo de una estimación grosso modo del tratamiento real administrado al
paciente. Las imágenes intraoperatorias del escenario real durante el tratamiento
(concretamente imágenes de tomografía axial computarizada [TAC]) serían útiles no
sólo para la planificación intraoperatoria, sino también para registrar y evaluar el
tratamiento administrado al paciente. Esta información es esencial en estudios
prospectivos.
En esta tesis se evaluó en primer lugar la viabilidad de un sistema de seguimiento
óptico de varias cámaras para obtener la posición/orientación del aplicador en los
escenarios de RIO con electrones. Los resultados mostraron un error de posición del
aplicador inferior a 2 mm (error medio del centro del bisel) y un error de orientación
menor de 2º (error medio del eje del bisel y del eje longitudinal del aplicador). Estos
valores están dentro del rango propuesto por el Grupo de Trabajo 147 (encargo del
Comité de Terapia y del Subcomité para la Mejora de la Garantía de Calidad y
Resultados de la Asociación Americana de Físicos en Medicina [AAPM] para estudiar
en radioterapia externa la exactitud de la localización con métodos no radiográficos,
como los sistemas infrarrojos). Una limitación importante de la solución propuesta es
que el aplicador se superpone a la imagen preoperatoria del paciente. Una imagen intraoperatoria proporcionaría información anatómica actualizada y permitiría estimar
la distribución tridimensional de la dosis.
El segundo estudio específico de esta tesis evaluó la viabilidad de adquirir con un TAC
simulador imágenes TAC intraoperatorias de escenarios reales de RIO con electrones.
No hubo complicaciones en la fase de transporte del paciente utilizando la camilla y su
acople para el transporte, o con la adquisición de imágenes TAC intraoperatorias en la
sala del TAC simulador. Los estudios intraoperatorios adquiridos se utilizaron para
evaluar la mejora obtenida en la estimación de la distribución de dosis en comparación
con la obtenida a partir de imágenes TAC preoperatorias, identificando el factor
dominante en esas estimaciones (la región de aire y las irregularidades en la superficie,
no las heterogeneidades de los tejidos).
Por último, el tercer estudio específico se centró en la evaluación de varias tecnologías
TAC de kilovoltaje, aparte del TAC simulador, para adquirir imágenes intraoperatorias
con las que estimar la distribución de la dosis en RIO con electrones. Estos dispositivos
serían necesarios en el caso de disponer de aceleradores lineales portátiles en el
quirófano ya que no se aprobaría mover al paciente a la sala del TAC simulador. Los
resultados con un maniquí abdominal mostraron que un TAC portátil (BodyTom) e
incluso un acelerador lineal con un TAC de haz de cónico (TrueBeam) serían
adecuados para este propósito.This thesis is framed within the field of radiotherapy, specifically intraoperative
electron radiotherapy (IOERT). This technique combines surgical resection of a tumour
and therapeutic radiation directly applied to a post-resection tumour bed or to an
unresected tumour. The high-energy electron beam is collimated and conducted by a
specific applicator docked to a linear accelerator (LINAC). Dosimetry planning for
IOERT is challenging owing to the geometrical and anatomical modifications produced
by the retraction of structures and removal of cancerous tissues during the surgery. No
data of the actual IOERT 3D scenario is available (for example, the applicator pose in
relation to the patient’s anatomy or the irregularities in the irradiated surface) and
consequently only a rough approximation of the actual IOERT treatment administered
to the patient can be estimated. Intraoperative computed tomography (CT) images of
the actual scenario during the treatment would be useful not only for intraoperative
planning but also for registering and evaluating the treatment administered to the
patient. This information is essential for prospective trials.
In this thesis, the feasibility of using a multi-camera optical tracking system to obtain
the applicator pose in IOERT scenarios was firstly assessed. Results showed that the
accuracy of the applicator pose was below 2 mm in position (mean error of the bevel
centre) and 2º in orientation (mean error of the bevel axis and the longitudinal axis),
which are within the acceptable range proposed in the recommendation of Task Group
147 (commissioned by the Therapy Committee and the Quality Assurance and
Outcomes Improvement Subcommittee of the American Association of Physicists in
Medicine [AAPM] to study the localization accuracy with non-radiographic methods
such as infrared systems in external beam radiation therapy). An important limitation
of this solution is that the actual pose of applicator is superimposed on a patient’s
preoperative image. An intraoperative image would provide updated anatomical
information and would allow estimating the 3D dose distribution.
The second specific study of this thesis evaluated the feasibility of acquiring
intraoperative CT images with a CT simulator in real IOERT scenarios. There were no
complications in the whole procedure related to the transport step using the subtable
and its stretcher or the acquisition of intraoperative CT images in the CT simulator
room. The acquired intraoperative studies were used to evaluate the improvement
achieved in the dose distribution estimation when compared to that obtained from
preoperative CT images, identifying the dominant factor in those estimations (air gap
and the surface irregularities, not tissue heterogeneities).
Finally, the last specific study focused on assessing several kilovoltage (kV) CT
technologies other than CT simulators to acquire intraoperative images for estimating
IOERT dose distribution. That would be necessary when a mobile electron LINAC was
available in the operating room as transferring the patient to the CT simulator room
could not be approved. Our results with an abdominal phantom revealed that a portable
CT (BodyTom) and even a LINAC with on-board kV cone-beam CT (TrueBeam)
would be suitable for this purpose.Programa Oficial de Doctorado en Multimedia y ComunicacionesPresidente: Joaquín López Herráiz.- Secretario: María Arrate Muñoz Barrutia.- Vocal: Óscar Acosta Tamay
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