Augmented Reality and Artificial Intelligence in Image-Guided and Robot-Assisted Interventions

In minimally invasive orthopedic procedures, the surgeon places wires, screws, and surgical implants through the muscles and bony structures under image guidance. These interventions require alignment of the pre- and intra-operative patient data, the intra-operative scanner, surgical instruments, and the patient. Suboptimal interaction with patient data and challenges in mastering 3D anatomy based on ill-posed 2D interventional images are essential concerns in image-guided therapies. State of the art approaches often support the surgeon by using external navigation systems or ill-conditioned image-based registration methods that both have certain drawbacks. Augmented reality (AR) has been introduced in the operating rooms in the last decade; however, in image-guided interventions, it has often only been considered as a visualization device improving traditional workflows. Consequently, the technology is gaining minimum maturity that it requires to redefine new procedures, user interfaces, and interactions. This dissertation investigates the applications of AR, artificial intelligence, and robotics in interventional medicine. Our solutions were applied in a broad spectrum of problems for various tasks, namely improving imaging and acquisition, image computing and analytics for registration and image understanding, and enhancing the interventional visualization. The benefits of these approaches were also discovered in robot-assisted interventions. We revealed how exemplary workflows are redefined via AR by taking full advantage of head-mounted displays when entirely co-registered with the imaging systems and the environment at all times. The proposed AR landscape is enabled by co-localizing the users and the imaging devices via the operating room environment and exploiting all involved frustums to move spatial information between different bodies. The system's awareness of the geometric and physical characteristics of X-ray imaging allows the exploration of different human-machine interfaces. We also leveraged the principles governing image formation and combined it with deep learning and RGBD sensing to fuse images and reconstruct interventional data. We hope that our holistic approaches towards improving the interface of surgery and enhancing the usability of interventional imaging, not only augments the surgeon's capabilities but also augments the surgical team's experience in carrying out an effective intervention with reduced complications

Conference on Intelligent Robotics in Field, Factory, Service, and Space (CIRFFSS 1994), volume 1

The AIAA/NASA Conference on Intelligent Robotics in Field, Factory, Service, and Space (CIRFFSS '94) was originally proposed because of the strong belief that America's problems of global economic competitiveness and job creation and preservation can partly be solved by the use of intelligent robotics, which are also required for human space exploration missions. Individual sessions addressed nuclear industry, agile manufacturing, security/building monitoring, on-orbit applications, vision and sensing technologies, situated control and low-level control, robotic systems architecture, environmental restoration and waste management, robotic remanufacturing, and healthcare applications

Proceedings of the NASA Conference on Space Telerobotics, volume 3

The theme of the Conference was man-machine collaboration in space. The Conference provided a forum for researchers and engineers to exchange ideas on the research and development required for application of telerobotics technology to the space systems planned for the 1990s and beyond. The Conference: (1) provided a view of current NASA telerobotic research and development; (2) stimulated technical exchange on man-machine systems, manipulator control, machine sensing, machine intelligence, concurrent computation, and system architectures; and (3) identified important unsolved problems of current interest which can be dealt with by future research

Sixth Annual Workshop on Space Operations Applications and Research (SOAR 1992), volume 2

This document contains papers presented at the Space Operations, Applications, and Research Symposium (SOAR) hosted by the U.S. Air Force (USAF) on 4-6 Aug. 1992. The symposium was cosponsored by the Air Force Material Command and by NASA/JSC. Key technical areas covered during the symposium were robotics and telepresence, automation and intelligent systems, human factors, life sciences, and space maintenance and servicing. The SOAR differed from most other conferences in that it was concerned with Government-sponsored research and development relevant to aerospace operations. Symposium proceedings include papers covering various disciplines presented by experts from NASA, the USAF, universities, and industry

Automatic image analysis of C-arm Computed Tomography images for ankle joint surgeries

Open reduction and internal fixation is a standard procedure in ankle surgery for treating a fractured fibula. Since fibula fractures are often accompanied by an injury of the syndesmosis complex, it is essential to restore the correct relative pose of the fibula relative to the adjoining tibia for the ligaments to heal. Otherwise, the patient might experience instability of the ankle leading to arthritis and ankle pain and ultimately revision surgery. Incorrect positioning referred to as malreduction of the fibula is assumed to be one of the major causes of unsuccessful ankle surgery. 3D C-arm imaging is the current standard procedure for revealing malreduction of fractures in the operating room. However, intra-operative visual inspection of the reduction result is complicated due to high inter-individual variation of the ankle anatomy and rather based on the subjective experience of the surgeon. A contralateral side comparison with the patient’s uninjured ankle is recommended but has not been integrated into clinical routine due to the high level of radiation exposure it incurs. This thesis presents the first approach towards a computer-assisted intra-operative contralateral side comparison of the ankle joint. The focus of this thesis was the design, development and validation of a software-based prototype for a fully automatic intra-operative assistance system for orthopedic surgeons. The implementation does not require an additional 3D C-arm scan of the uninjured ankle, thus reducing time consumption and cumulative radiation dose. A 3D statistical shape model (SSM) is used to reconstruct a 3D surface model from three 2D fluoroscopic projections representing the uninjured ankle. To this end, a 3D SSM segmentation is performed on the 3D image of the injured ankle to gain prior knowledge of the ankle. A 3D convolutional neural network (CNN) based initialization method was developed and its outcome was incorporated into the SSM adaption step. Segmentation quality was shown to be improved in terms of accuracy and robustness compared to the pure intensity-based SSM. This allows us to overcome the limitations of the previously proposed methods, namely inaccuracy due to metal artifacts and the lack of device-to-patient orientation of the C-arm. A 2D-CNN is employed to extract semantic knowledge from all fluoroscopic projection images. This step of the pipeline both creates features for the subsequent reconstruction and also helps to pre-initialize the 3D-SSM without user interaction. A 2D-3D multi-bone reconstruction method has been developed which uses distance maps of the 2D features for fast and accurate correspondence optimization and SSM adaption. This is the central and most crucial component of the workflow. This is the first time that a bone reconstruction method has been applied to the complex ankle joint and the first reconstruction method using CNN based segmentations as features. The reconstructed 3D-SSM of the uninjured ankle can be back-projected and visualized in a workflow-oriented manner to procure clear visualization of the region of interest, which is essential for the evaluation of the reduction result. The surgeon can thus directly compare an overlay of the contralateral ankle with the injured ankle. The developed methods were evaluated individually using data sets acquired during a cadaver study and representative clinical data acquired during fibular reduction. A hierarchical evaluation was designed to assess the inaccuracies of the system on different levels and to identify major sources of error. The overall evaluation performed on eleven challenging clinical datasets acquired for manual contralateral side comparison showed that the system is capable of accurately reconstructing 3D surface models of the uninjured ankle solely using three projection images. A mean Hausdorff distance of 1.72 mm was measured when comparing the reconstruction result to the ground truth segmentation and almost achieved the high required clinical accuracy of 1-2 mm. The overall error of the pipeline was mainly attributed to inaccuracies in the 2D-CNN segmentation. The consistency of these results requires further validation on a larger dataset. The workflow proposed in this thesis establishes the first approach to enable automatic computer-assisted contralateral side comparison in ankle surgery. The feasibility of the proposed approach was proven on a limited amount of clinical cases and has already yielded good results. The next important step is to alleviate the identified bottlenecks in the approach by providing more training data in order to further improve the accuracy. In conclusion, the new approach presented gives the chance to guide the surgeon during the reduction process, improve the surgical outcome while avoiding additional radiation exposure and reduce the number of revision surgeries in the long term

Technology 2001: The Second National Technology Transfer Conference and Exposition, volume 2

Proceedings of the workshop are presented. The mission of the conference was to transfer advanced technologies developed by the Federal government, its contractors, and other high-tech organizations to U.S. industries for their use in developing new or improved products and processes. Volume two presents papers on the following topics: materials science, robotics, test and measurement, advanced manufacturing, artificial intelligence, biotechnology, electronics, and software engineering

Annals of Scientific Society for Assembly, Handling and Industrial Robotics 2021

This Open Access proceedings presents a good overview of the current research landscape of assembly, handling and industrial robotics. The objective of MHI Colloquium is the successful networking at both academic and management level. Thereby, the colloquium focuses an academic exchange at a high level in order to distribute the obtained research results, to determine synergy effects and trends, to connect the actors in person and in conclusion, to strengthen the research field as well as the MHI community. In addition, there is the possibility to become acquatined with the organizing institute. Primary audience is formed by members of the scientific society for assembly, handling and industrial robotics (WGMHI)