Navigation system based in motion tracking sensor for percutaneous renal access

Tese de Doutoramento em Engenharia BiomédicaMinimally-invasive kidney interventions are daily performed to diagnose and treat several renal diseases. Percutaneous renal access (PRA) is an essential but challenging stage for most of these procedures, since its outcome is directly linked to the physician’s ability to precisely visualize and reach the anatomical target. Nowadays, PRA is always guided with medical imaging assistance, most frequently using X-ray based imaging (e.g. fluoroscopy). Thus, radiation on the surgical theater represents a major risk to the medical team, where its exclusion from PRA has a direct impact diminishing the dose exposure on both patients and physicians. To solve the referred problems this thesis aims to develop a new hardware/software framework to intuitively and safely guide the surgeon during PRA planning and puncturing. In terms of surgical planning, a set of methodologies were developed to increase the certainty of reaching a specific target inside the kidney. The most relevant abdominal structures for PRA were automatically clustered into different 3D volumes. For that, primitive volumes were merged as a local optimization problem using the minimum description length principle and image statistical properties. A multi-volume Ray Cast method was then used to highlight each segmented volume. Results show that it is possible to detect all abdominal structures surrounding the kidney, with the ability to correctly estimate a virtual trajectory. Concerning the percutaneous puncturing stage, either an electromagnetic or optical solution were developed and tested in multiple in vitro, in vivo and ex vivo trials. The optical tracking solution aids in establishing the desired puncture site and choosing the best virtual puncture trajectory. However, this system required a line of sight to different optical markers placed at the needle base, limiting the accuracy when tracking inside the human body. Results show that the needle tip can deflect from its initial straight line trajectory with an error higher than 3 mm. Moreover, a complex registration procedure and initial setup is needed. On the other hand, a real-time electromagnetic tracking was developed. Hereto, a catheter was inserted trans-urethrally towards the renal target. This catheter has a position and orientation electromagnetic sensor on its tip that function as a real-time target locator. Then, a needle integrating a similar sensor is used. From the data provided by both sensors, one computes a virtual puncture trajectory, which is displayed in a 3D visualization software. In vivo tests showed a median renal and ureteral puncture times of 19 and 51 seconds, respectively (range 14 to 45 and 45 to 67 seconds). Such results represent a puncture time improvement between 75% and 85% when comparing to state of the art methods. 3D sound and vibrotactile feedback were also developed to provide additional information about the needle orientation. By using these kind of feedback, it was verified that the surgeon tends to follow a virtual puncture trajectory with a reduced amount of deviations from the ideal trajectory, being able to anticipate any movement even without looking to a monitor. Best results show that 3D sound sources were correctly identified 79.2 ± 8.1% of times with an average angulation error of 10.4º degrees. Vibration sources were accurately identified 91.1 ± 3.6% of times with an average angulation error of 8.0º degrees. Additionally to the EMT framework, three circular ultrasound transducers were built with a needle working channel. One explored different manufacture fabrication setups in terms of the piezoelectric materials, transducer construction, single vs. multi array configurations, backing and matching material design. The A-scan signals retrieved from each transducer were filtered and processed to automatically detect reflected echoes and to alert the surgeon when undesirable anatomical structures are in between the puncture path. The transducers were mapped in a water tank and tested in a study involving 45 phantoms. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Hereupon, it is expected that the introduction of the proposed system on the PRA procedure, will allow to guide the surgeon through the optimal path towards the precise kidney target, increasing surgeon’s confidence and reducing complications (e.g. organ perforation) during PRA. Moreover, the developed framework has the potential to make the PRA free of radiation for both patient and surgeon and to broad the use of PRA to less specialized surgeons.Intervenções renais minimamente invasivas são realizadas diariamente para o tratamento e diagnóstico de várias doenças renais. O acesso renal percutâneo (ARP) é uma etapa essencial e desafiante na maior parte destes procedimentos. O seu resultado encontra-se diretamente relacionado com a capacidade do cirurgião visualizar e atingir com precisão o alvo anatómico. Hoje em dia, o ARP é sempre guiado com recurso a sistemas imagiológicos, na maior parte das vezes baseados em raios-X (p.e. a fluoroscopia). A radiação destes sistemas nas salas cirúrgicas representa um grande risco para a equipa médica, aonde a sua remoção levará a um impacto direto na diminuição da dose exposta aos pacientes e cirurgiões. De modo a resolver os problemas existentes, esta tese tem como objetivo o desenvolvimento de uma framework de hardware/software que permita, de forma intuitiva e segura, guiar o cirurgião durante o planeamento e punção do ARP. Em termos de planeamento, foi desenvolvido um conjunto de metodologias de modo a aumentar a eficácia com que o alvo anatómico é alcançado. As estruturas abdominais mais relevantes para o procedimento de ARP, foram automaticamente agrupadas em volumes 3D, através de um problema de optimização global com base no princípio de “minimum description length” e propriedades estatísticas da imagem. Por fim, um procedimento de Ray Cast, com múltiplas funções de transferência, foi utilizado para enfatizar as estruturas segmentadas. Os resultados mostram que é possível detetar todas as estruturas abdominais envolventes ao rim, com a capacidade para estimar corretamente uma trajetória virtual. No que diz respeito à fase de punção percutânea, foram testadas duas soluções de deteção de movimento (ótica e eletromagnética) em múltiplos ensaios in vitro, in vivo e ex vivo. A solução baseada em sensores óticos ajudou no cálculo do melhor ponto de punção e na definição da melhor trajetória a seguir. Contudo, este sistema necessita de uma linha de visão com diferentes marcadores óticos acoplados à base da agulha, limitando a precisão com que a agulha é detetada no interior do corpo humano. Os resultados indicam que a agulha pode sofrer deflexões à medida que vai sendo inserida, com erros superiores a 3 mm. Por outro lado, foi desenvolvida e testada uma solução com base em sensores eletromagnéticos. Para tal, um cateter que integra um sensor de posição e orientação na sua ponta, foi colocado por via trans-uretral junto do alvo renal. De seguida, uma agulha, integrando um sensor semelhante, é utilizada para a punção percutânea. A partir da diferença espacial de ambos os sensores, é possível gerar uma trajetória de punção virtual. A mediana do tempo necessário para puncionar o rim e ureter, segundo esta trajetória, foi de 19 e 51 segundos, respetivamente (variações de 14 a 45 e 45 a 67 segundos). Estes resultados representam uma melhoria do tempo de punção entre 75% e 85%, quando comparados com o estado da arte dos métodos atuais. Além do feedback visual, som 3D e feedback vibratório foram explorados de modo a fornecer informações complementares da posição da agulha. Verificou-se que com este tipo de feedback, o cirurgião tende a seguir uma trajetória de punção com desvios mínimos, sendo igualmente capaz de antecipar qualquer movimento, mesmo sem olhar para o monitor. Fontes de som e vibração podem ser corretamente detetadas em 79,2 ± 8,1% e 91,1 ± 3,6%, com erros médios de angulação de 10.4º e 8.0 graus, respetivamente. Adicionalmente ao sistema de navegação, foram também produzidos três transdutores de ultrassom circulares com um canal de trabalho para a agulha. Para tal, foram exploradas diferentes configurações de fabricação em termos de materiais piezoelétricos, transdutores multi-array ou singulares e espessura/material de layers de suporte. Os sinais originados em cada transdutor foram filtrados e processados de modo a detetar de forma automática os ecos refletidos, e assim, alertar o cirurgião quando existem variações anatómicas ao longo do caminho de punção. Os transdutores foram mapeados num tanque de água e testados em 45 phantoms. Os resultados mostraram que o feixe de área em corte transversal oscila em torno do raio de cerâmica, e que os ecos refletidos são detetados em phantoms com comprimentos superiores a 80 mm. Desta forma, é expectável que a introdução deste novo sistema a nível do ARP permitirá conduzir o cirurgião ao longo do caminho de punção ideal, aumentado a confiança do cirurgião e reduzindo possíveis complicações (p.e. a perfuração dos órgãos). Além disso, de realçar que este sistema apresenta o potencial de tornar o ARP livre de radiação e alarga-lo a cirurgiões menos especializados.The present work was only possible thanks to the support by the Portuguese Science and Technology Foundation through the PhD grant with reference SFRH/BD/74276/2010 funded by FCT/MEC (PIDDAC) and by Fundo Europeu de Desenvolvimento Regional (FEDER), Programa COMPETE - Programa Operacional Factores de Competitividade (POFC) do QREN

Sonic interactions in virtual environments

This book tackles the design of 3D spatial interactions in an audio-centered and audio-first perspective, providing the fundamental notions related to the creation and evaluation of immersive sonic experiences. The key elements that enhance the sensation of place in a virtual environment (VE) are: Immersive audio: the computational aspects of the acoustical-space properties of Virutal Reality (VR) technologies Sonic interaction: the human-computer interplay through auditory feedback in VE VR systems: naturally support multimodal integration, impacting different application domains Sonic Interactions in Virtual Environments will feature state-of-the-art research on real-time auralization, sonic interaction design in VR, quality of the experience in multimodal scenarios, and applications. Contributors and editors include interdisciplinary experts from the fields of computer science, engineering, acoustics, psychology, design, humanities, and beyond. Their mission is to shape an emerging new field of study at the intersection of sonic interaction design and immersive media, embracing an archipelago of existing research spread in different audio communities and to increase among the VR communities, researchers, and practitioners, the awareness of the importance of sonic elements when designing immersive environments

Sonic Interactions in Virtual Environments

This open access book tackles the design of 3D spatial interactions in an audio-centered and audio-first perspective, providing the fundamental notions related to the creation and evaluation of immersive sonic experiences. The key elements that enhance the sensation of place in a virtual environment (VE) are: Immersive audio: the computational aspects of the acoustical-space properties of Virutal Reality (VR) technologies Sonic interaction: the human-computer interplay through auditory feedback in VE VR systems: naturally support multimodal integration, impacting different application domains Sonic Interactions in Virtual Environments will feature state-of-the-art research on real-time auralization, sonic interaction design in VR, quality of the experience in multimodal scenarios, and applications. Contributors and editors include interdisciplinary experts from the fields of computer science, engineering, acoustics, psychology, design, humanities, and beyond. Their mission is to shape an emerging new field of study at the intersection of sonic interaction design and immersive media, embracing an archipelago of existing research spread in different audio communities and to increase among the VR communities, researchers, and practitioners, the awareness of the importance of sonic elements when designing immersive environments

Sonic Interactions in Virtual Environments

This open access book tackles the design of 3D spatial interactions in an audio-centered and audio-first perspective, providing the fundamental notions related to the creation and evaluation of immersive sonic experiences. The key elements that enhance the sensation of place in a virtual environment (VE) are: Immersive audio: the computational aspects of the acoustical-space properties of Virutal Reality (VR) technologies Sonic interaction: the human-computer interplay through auditory feedback in VE VR systems: naturally support multimodal integration, impacting different application domains Sonic Interactions in Virtual Environments will feature state-of-the-art research on real-time auralization, sonic interaction design in VR, quality of the experience in multimodal scenarios, and applications. Contributors and editors include interdisciplinary experts from the fields of computer science, engineering, acoustics, psychology, design, humanities, and beyond. Their mission is to shape an emerging new field of study at the intersection of sonic interaction design and immersive media, embracing an archipelago of existing research spread in different audio communities and to increase among the VR communities, researchers, and practitioners, the awareness of the importance of sonic elements when designing immersive environments

Advancing proxy-based haptic feedback in virtual reality

This thesis advances haptic feedback for Virtual Reality (VR). Our work is guided by Sutherland's 1965 vision of the ultimate display, which calls for VR systems to control the existence of matter. To push towards this vision, we build upon proxy-based haptic feedback, a technique characterized by the use of passive tangible props. The goal of this thesis is to tackle the central drawback of this approach, namely, its inflexibility, which yet hinders it to fulfill the vision of the ultimate display. Guided by four research questions, we first showcase the applicability of proxy-based VR haptics by employing the technique for data exploration. We then extend the VR system's control over users' haptic impressions in three steps. First, we contribute the class of Dynamic Passive Haptic Feedback (DPHF) alongside two novel concepts for conveying kinesthetic properties, like virtual weight and shape, through weight-shifting and drag-changing proxies. Conceptually orthogonal to this, we study how visual-haptic illusions can be leveraged to unnoticeably redirect the user's hand when reaching towards props. Here, we contribute a novel perception-inspired algorithm for Body Warping-based Hand Redirection (HR), an open-source framework for HR, and psychophysical insights. The thesis concludes by proving that the combination of DPHF and HR can outperform the individual techniques in terms of the achievable flexibility of the proxy-based haptic feedback.Diese Arbeit widmet sich haptischem Feedback für Virtual Reality (VR) und ist inspiriert von Sutherlands Vision des ultimativen Displays, welche VR-Systemen die Fähigkeit zuschreibt, Materie kontrollieren zu können. Um dieser Vision näher zu kommen, baut die Arbeit auf dem Konzept proxy-basierter Haptik auf, bei der haptische Eindrücke durch anfassbare Requisiten vermittelt werden. Ziel ist es, diesem Ansatz die für die Realisierung eines ultimativen Displays nötige Flexibilität zu verleihen. Dazu bearbeiten wir vier Forschungsfragen und zeigen zunächst die Anwendbarkeit proxy-basierter Haptik durch den Einsatz der Technik zur Datenexploration. Anschließend untersuchen wir in drei Schritten, wie VR-Systeme mehr Kontrolle über haptische Eindrücke von Nutzern erhalten können. Hierzu stellen wir Dynamic Passive Haptic Feedback (DPHF) vor, sowie zwei Verfahren, die kinästhetische Eindrücke wie virtuelles Gewicht und Form durch Gewichtsverlagerung und Veränderung des Luftwiderstandes von Requisiten vermitteln. Zusätzlich untersuchen wir, wie visuell-haptische Illusionen die Hand des Nutzers beim Greifen nach Requisiten unbemerkt umlenken können. Dabei stellen wir einen neuen Algorithmus zur Body Warping-based Hand Redirection (HR), ein Open-Source-Framework, sowie psychophysische Erkenntnisse vor. Abschließend zeigen wir, dass die Kombination von DPHF und HR proxy-basierte Haptik noch flexibler machen kann, als es die einzelnen Techniken alleine können

RecHap: An Interactive Recommender System For Navigating Large Dataset of Mid-Air Haptic Designs

Designing haptics is a difficult task especially when the user attempts to design a sensation from scratch for a novel experience. In the fields of visual and audio design, designers often use large example libraries for inspiration, supported by intelligent systems like recommender systems. In this thesis, we contribute a corpus of 5327 mid-air haptic designs (two orders of magnitude larger than existing haptic libraries), and use it to explore a new approach for both novices and experienced hapticians to use these examples in mid-air haptic design. RecHap design tool utilises an autoencoder-based recommendation system that suggests preexisting examples by sampling various regions of the encoded latent space. The tool also provides a graphical user interface for designers to visualize the sensation in 3D view, select previous designs, and bookmark favourites. According to the study conducted, it was evident that the tool allowed designers to quickly sketch ideas and experience them right away. Design suggestions encouraged collaboration, expression, exploration, and enjoyment, which improved creativity

Modelling, Simulation and Data Analysis in Acoustical Problems

Modelling and simulation in acoustics is currently gaining importance. In fact, with the development and improvement of innovative computational techniques and with the growing need for predictive models, an impressive boost has been observed in several research and application areas, such as noise control, indoor acoustics, and industrial applications. This led us to the proposal of a special issue about “Modelling, Simulation and Data Analysis in Acoustical Problems”, as we believe in the importance of these topics in modern acoustics’ studies. In total, 81 papers were submitted and 33 of them were published, with an acceptance rate of 37.5%. According to the number of papers submitted, it can be affirmed that this is a trending topic in the scientific and academic community and this special issue will try to provide a future reference for the research that will be developed in coming years

Sensorimotor interfaces : towards enactivity in HCI

This thesis explores the application of enactive techniques to human computer interaction, focusing on how devices following ‘sensorimotor’ principles can be blended with interface goals to lead to new perceptual experiences. Building sensorimotor interfaces is an exciting, emerging field of research facing challenges surrounding application, design, training and uptake. To tackle these challenges, this thesis cuts a line of investigation from a review of enactivity in the related field of sensory substitution and augmentation devices, to a schematic taxonomy, model and design guide of ‘the sensorimotor interface’; developed from a theoretically-grounded, enactive approach to cognition. Device, interaction and training guidelines are drawn from this model, formalising the application of the enactive approach to HCI. A readily-available consumer device is then characterised and calibrated in preparation for testing the model validity and associated insights. The process highlights the effects of accessible, easily-implemented calibrations, and the importance of mixed-method approaches in assessing sensorimotor interface potential. The calibrated device is utilised to conduct a detailed, methodological investigation into how concurrently available sensory information affects and contributes to uptake of novel sensorimotor skills. Robust statistical modelling concludes that sensory concurrency has a profound effect on the comprehension and integration of enactive haptic signals, and that efforts to carefully control the nature and degree of sensory concurrency improve user comprehension and enjoyability when engaging with novel sensorimotor tasks, while reducing confusion and stress. The work is concluded by speculation on how the presented derivations, methods and observations can be used to directly influence future sensorimotor interface design in HCI. This thesis therefore constitutes a primer to the principles and history of sensory substitution and augmentation, details the requirements and limitations of the enactive approach in academia and industry, and brings enactivity forward as an accessible, viable and exciting methodology in interaction design