UV Exposed Optical Fibers with Frequency Domain Reflectometry for Device Tracking in Intra-Arterial Procedures

Shape tracking of medical devices using strain sensing properties in optical fibers has seen increased attention in recent years. In this paper, we propose a novel guidance system for intra-arterial procedures using a distributed strain sensing device based on optical frequency domain reflectometry (OFDR) to track the shape of a catheter. Tracking enhancement is provided by exposing a fiber triplet to a focused ultraviolet beam, producing high scattering properties. Contrary to typical quasi-distributed strain sensors, we propose a truly distributed strain sensing approach, which allows to reconstruct a fiber triplet in real-time. A 3D roadmap of the hepatic anatomy integrated with a 4D MR imaging sequence allows to navigate the catheter within the pre-interventional anatomy, and map the blood flow velocities in the arterial tree. We employed Riemannian anisotropic heat kernels to map the sensed data to the pre-interventional model. Experiments in synthetic phantoms and an in vivo model are presented. Results show that the tracking accuracy is suitable for interventional tracking applications, with a mean 3D shape reconstruction errors of 1.6 +/- 0.3 mm. This study demonstrates the promising potential of MR-compatible UV-exposed OFDR optical fibers for non-ionizing device guidance in intra-arterial procedures

Implicit active constraints for safe and effective guidance of unstable concentric tube robots

Safe and effective telemanipulation of concentric tube robots is hindered by their complex, non-intuitive kinematics. In order for clinicians to operate these robots naturally, guidance schemes in the form of attractive and repulsive constraints can simplify task execution. The real-time seamless calculation and application of guidance, however, requires computationally efficient algorithms that solve the non-linear inverse kinematics of the robot and guarantee that the commanded robot configuration is stable and sufficiently away from the anatomy. This paper presents a multi-processor framework that allows on-the-fly calculation of optimal safe paths based on rapid workspace and roadmap precomputation. The realtime nature of the developed software enables complex guidance constraints to be implemented with minimal computational overhead. A clinically challenging user study demonstrates that the incorporated guiding constraints are highly beneficial for fast and accurate navigation with concentric tube robots

Internet of robotic things : converging sensing/actuating, hypoconnectivity, artificial intelligence and IoT Platforms

The Internet of Things (IoT) concept is evolving rapidly and influencing newdevelopments in various application domains, such as the Internet of MobileThings (IoMT), Autonomous Internet of Things (A-IoT), Autonomous Systemof Things (ASoT), Internet of Autonomous Things (IoAT), Internetof Things Clouds (IoT-C) and the Internet of Robotic Things (IoRT) etc.that are progressing/advancing by using IoT technology. The IoT influencerepresents new development and deployment challenges in different areassuch as seamless platform integration, context based cognitive network integration,new mobile sensor/actuator network paradigms, things identification(addressing, naming in IoT) and dynamic things discoverability and manyothers. The IoRT represents new convergence challenges and their need to be addressed, in one side the programmability and the communication ofmultiple heterogeneous mobile/autonomous/robotic things for cooperating,their coordination, configuration, exchange of information, security, safetyand protection. Developments in IoT heterogeneous parallel processing/communication and dynamic systems based on parallelism and concurrencyrequire new ideas for integrating the intelligent “devices”, collaborativerobots (COBOTS), into IoT applications. Dynamic maintainability, selfhealing,self-repair of resources, changing resource state, (re-) configurationand context based IoT systems for service implementation and integrationwith IoT network service composition are of paramount importance whennew “cognitive devices” are becoming active participants in IoT applications.This chapter aims to be an overview of the IoRT concept, technologies,architectures and applications and to provide a comprehensive coverage offuture challenges, developments and applications

Image guidance in neurosurgical procedures, the "Visages" point of view.

This paper gives an overview of the evolution of clinical neuroinformatics in the domain of neurosurgery. It shows how image guided neurosurgery (IGNS) is evolving according to the integration of new imaging modalities before, during and after the surgical procedure and how this acts as the premise of the Operative Room of the future. These different issues, as addressed by the VisAGeS INRIA/INSERM U746 research team (http://www.irisa.fr/visages), are presented and discussed in order to exhibit the benefits of an integrated work between physicians (radiologists, neurologists and neurosurgeons) and computer scientists to give adequate answers toward a more effective use of images in IGNS

Development of a Surgical Assistance System for Guiding Transcatheter Aortic Valve Implantation

Development of image-guided interventional systems is growing up rapidly in the recent years. These new systems become an essential part of the modern minimally invasive surgical procedures, especially for the cardiac surgery. Transcatheter aortic valve implantation (TAVI) is a recently developed surgical technique to treat severe aortic valve stenosis in elderly and high-risk patients. The placement of stented aortic valve prosthesis is crucial and typically performed under live 2D fluoroscopy guidance. To assist the placement of the prosthesis during the surgical procedure, a new fluoroscopy-based TAVI assistance system has been developed. The developed assistance system integrates a 3D geometrical aortic mesh model and anatomical valve landmarks with live 2D fluoroscopic images. The 3D aortic mesh model and landmarks are reconstructed from interventional angiographic and fluoroscopic C-arm CT system, and a target area of valve implantation is automatically estimated using these aortic mesh models. Based on template-based tracking approach, the overlay of visualized 3D aortic mesh model, landmarks and target area of implantation onto fluoroscopic images is updated by approximating the aortic root motion from a pigtail catheter motion without contrast agent. A rigid intensity-based registration method is also used to track continuously the aortic root motion in the presence of contrast agent. Moreover, the aortic valve prosthesis is tracked in fluoroscopic images to guide the surgeon to perform the appropriate placement of prosthesis into the estimated target area of implantation. An interactive graphical user interface for the surgeon is developed to initialize the system algorithms, control the visualization view of the guidance results, and correct manually overlay errors if needed. Retrospective experiments were carried out on several patient datasets from the clinical routine of the TAVI in a hybrid operating room. The maximum displacement errors were small for both the dynamic overlay of aortic mesh models and tracking the prosthesis, and within the clinically accepted ranges. High success rates of the developed assistance system were obtained for all tested patient datasets. The results show that the developed surgical assistance system provides a helpful tool for the surgeon by automatically defining the desired placement position of the prosthesis during the surgical procedure of the TAVI.Die Entwicklung bildgeführter interventioneller Systeme wächst rasant in den letzten Jahren. Diese neuen Systeme werden zunehmend ein wesentlicher Bestandteil der technischen Ausstattung bei modernen minimal-invasiven chirurgischen Eingriffen. Diese Entwicklung gilt besonders für die Herzchirurgie. Transkatheter Aortenklappen-Implantation (TAKI) ist eine neue entwickelte Operationstechnik zur Behandlung der schweren Aortenklappen-Stenose bei alten und Hochrisiko-Patienten. Die Platzierung der Aortenklappenprothese ist entscheidend und wird in der Regel unter live-2D-fluoroskopischen Bildgebung durchgeführt. Zur Unterstützung der Platzierung der Prothese während des chirurgischen Eingriffs wurde in dieser Arbeit ein neues Fluoroskopie-basiertes TAKI Assistenzsystem entwickelt. Das entwickelte Assistenzsystem überlagert eine 3D-Geometrie des Aorten-Netzmodells und anatomischen Landmarken auf live-2D-fluoroskopische Bilder. Das 3D-Aorten-Netzmodell und die Landmarken werden auf Basis der interventionellen Angiographie und Fluoroskopie mittels eines C-Arm-CT-Systems rekonstruiert. Unter Verwendung dieser Aorten-Netzmodelle wird das Zielgebiet der Klappen-Implantation automatisch geschätzt. Mit Hilfe eines auf Template Matching basierenden Tracking-Ansatzes wird die Überlagerung des visualisierten 3D-Aorten-Netzmodells, der berechneten Landmarken und der Zielbereich der Implantation auf fluoroskopischen Bildern korrekt überlagert. Eine kompensation der Aortenwurzelbewegung erfolgt durch Bewegungsverfolgung eines Pigtail-Katheters in Bildsequenzen ohne Kontrastmittel. Eine starrere Intensitätsbasierte Registrierungsmethode wurde verwendet, um kontinuierlich die Aortenwurzelbewegung in Bildsequenzen mit Kontrastmittelgabe zu detektieren. Die Aortenklappenprothese wird in die fluoroskopischen Bilder eingeblendet und dient dem Chirurg als Leitfaden für die richtige Platzierung der realen Prothese. Eine interaktive Benutzerschnittstelle für den Chirurg wurde zur Initialisierung der Systemsalgorithmen, zur Steuerung der Visualisierung und für manuelle Korrektur eventueller Überlagerungsfehler entwickelt. Retrospektive Experimente wurden an mehreren Patienten-Datensätze aus der klinischen Routine der TAKI in einem Hybrid-OP durchgeführt. Hohe Erfolgsraten des entwickelten Assistenzsystems wurden für alle getesteten Patienten-Datensätze erzielt. Die Ergebnisse zeigen, dass das entwickelte chirurgische Assistenzsystem ein hilfreiches Werkzeug für den Chirurg bei der Platzierung Position der Prothese während des chirurgischen Eingriffs der TAKI bietet

Accurate,robust and harmonized implementation of morpho-functional imaging in treatment planning for personalized radiotherapy

In this work we present a methodology able to use harmonized PET/CT imaging in dose painting by number (DPBN) approach by means of a robust and accurate treatment planning system. Image processing and treatment planning were performed by using a Matlab-based platform, called CARMEN, in which a full Monte Carlo simulation is included. Linear programming formulation was developed for a voxel-by-voxel robust optimization and a specific direct aperture optimization was designed for an efficient adaptive radiotherapy implementation. DPBN approach with our methodology was tested to reduce the uncertainties associated with both, the absolute value and the relative value of the information in the functional image. For the same H&N case, a single robust treatment was planned for dose prescription maps corresponding to standardized uptake value distributions from two different image reconstruction protocols: One to fulfill EARL accreditation for harmonization of [18F]FDG PET/CT image, and the other one to use the highest available spatial resolution. Also, a robust treatment was planned to fulfill dose prescription maps corresponding to both approaches, the dose painting by contour based on volumes and our voxel-by-voxel DPBN. Adaptive planning was also carried out to check the suitability of our proposal. Different plans showed robustness to cover a range of scenarios for implementation of harmonizing strategies by using the highest available resolution. Also, robustness associated to discretization level of dose prescription according to the use of contours or numbers was achieved. All plans showed excellent quality index histogram and quality factors below 2%. Efficient solution for adaptive radiotherapy based directly on changes in functional image was obtained. We proved that by using voxel-by-voxel DPBN approach it is possible to overcome typical drawbacks linked to PET/CT images, providing to the clinical specialist confidence enough for routinely implementation of functional imaging for personalized radiotherapy.Junta de Andalucía (FISEVI, reference project CTS 2482)European Regional Development Fund (FEDER

Guest Editorial Special Issue on Medical Imaging and Image Computing in Computational Physiology

International audienceThe January 2013 Special Issue of IEEE transactions on medical imaging discusses papers on medical imaging and image computing in computational physiology. Aslanid and co-researchers present an experimental technique based on stained micro computed tomography (CT) images to construct very detailed atrial models of the canine heart. The paper by Sebastian proposes a model of the cardiac conduction system (CCS) based on structural information derived from stained calf tissue. Ho, Mithraratne and Hunter present a numerical simulation of detailed cerebral venous flow. The third category of papers deals with computational methods for simulating medical imagery and incorporate knowledge of imaging physics and physiology/biophysics. The work by Morales showed how the combination of device modeling and virtual deployment, in addition to patient-specific image-based anatomical modeling, can help to carry out patient-specific treatment plans and assess alternative therapeutic strategies