Vision-based and marker-less surgical tool detection and tracking: a review of the literature

In recent years, tremendous progress has been made in surgical practice for example with Minimally Invasive Surgery (MIS). To overcome challenges coming from deported eye-to-hand manipulation, robotic and computer-assisted systems have been developed. Having real-time knowledge of the pose of surgical tools with respect to the surgical camera and underlying anatomy is a key ingredient for such systems. In this paper, we present a review of the literature dealing with vision-based and marker-less surgical tool detection. This paper includes three primary contributions: (1) identification and analysis of data-sets used for developing and testing detection algorithms, (2) in-depth comparison of surgical tool detection methods from the feature extraction process to the model learning strategy and highlight existing shortcomings, and (3) analysis of validation techniques employed to obtain detection performance results and establish comparison between surgical tool detectors. The papers included in the review were selected through PubMed and Google Scholar searches using the keywords: “surgical tool detection”, “surgical tool tracking”, “surgical instrument detection” and “surgical instrument tracking” limiting results to the year range 2000 2015. Our study shows that despite significant progress over the years, the lack of established surgical tool data-sets, and reference format for performance assessment and method ranking is preventing faster improvement

Update on field use of the available drugs for the chemotherapy of human African trypanosomiasis

Despite the fact that eflornithine was considered as the safer drug to treat human African trypanosomiasis (HAT) and has been freely available since 2001, the difficulties in logistics and cost burden associated with this drug meant that the toxic melarsoprol remained the drug of choice. The World Health Organization responded to the situation by designing a medical kit containing all the materials needed to use eflornithine, and by implementing a training and drugs distribution programme which has allowed a transition to this much safer treatment. The introduction of the combination of nifurtimox and eflornithine (NECT) has accelerated the shift from melarsoprol to the best treatment available, due to reduced dosage and treatment time for eflornithine that has significantly lessened the cost and improved the burden of logistics encountered during treatment and distribution. The decrease in the use of more dangerous but cheaper melarsoprol has meant a rise in the per patient cost of treating HAT. Although NECT is cheaper than eflornithine monotherapy, an unexpected consequence has been a continuing rise in the per patient cost of treating HAT. The ethical decision of shifting to the best available treatment imposes a financial burden on HAT control programmes that might render long-term application unsustainable. These factors call for continuing research to provide new safer and more effective drugs that are simple to administer and cheaper when compared to current drug

Acquisition models in intraoperative positron surface imaging

PURPOSE: Intraoperative imaging aims at identifying residual tumor during surgery. Positron Surface Imaging (PSI) is one of the solutions to help surgeons in a better detection of resection margins of brain tumor, leading to an improved patient outcome. This system relies on a tracked freehand beta probe, using [Formula: see text]F-based radiotracer. Some acquisition models have been proposed in the literature in order to enhance image quality, but no comparative validation study has been performed for PSI. METHODS: In this study, we investigated the performance of different acquisition models by considering validation criteria and normalized metrics. We proposed a reference-based validation framework to perform the comparative study between acquisition models and a basic method. We estimated the performance of several acquisition models in light of four validation criteria: efficiency, computational speed, spatial accuracy and tumor contrast. RESULTS: Selected acquisition models outperformed the basic method, albeit with the real-time aspect compromised. One acquisition model yielded the best performance among all according to the validation criteria: efficiency (1-Spe: 0.1, Se: 0.94), spatial accuracy (max Dice: 0.77) and tumor contrast (max T/B: 5.2). We also found out that above a minimum threshold value of the sampling rate, the reconstruction quality does not vary significantly. CONCLUSION: Our method allowed the comparison of different acquisition models and highlighted one of them according to our validation criteria. This novel approach can be extended to 3D datasets, for validation of future acquisition models dedicated to intraoperative guidance of brain surgery

Trypanosomiase humaine africaine : étude d'un score de présomption de diagnostic au Congo

Une enquête cas-témoins a été réalisée au Congo afin de définir une grille de score de présomption de la maladie du sommeil à #T.b. gambiense$, basée sur une sélection de critères cliniques et épidémiologiques de la trypanosomiase, utilisable par les structures sanitaires périphériques. L'enquête a été réalisée sur 163 cas et 326 témoins. Les signes cliniques et les symptômes retenus sont :fièvre, céphalées, prurit et lésions de grattage, diarrhée, oedèmes, adénopathies cervicales, troubles du sommeil, troubles de l'appétit, troubles sexuels, psychisme, signes neurologiques et autres troubles cliniques mineurs. Les autres critères retenus sont les antécédents de trypanosomiase humaine africaine (THA) et l'existence d'un cheptel dans la concession. L'analyse des résultats confirme qu'il n'existe pas de critère ou groupe de critères pathognomoniques. Aucun des critères sélectionnés n'est suffisamment discriminant pour permettre une sélection des trypanosomés parmi les consultants. Une grille de score de présomption semble donc de peu d'utilité au niveau périphérique; ceci est d'autant plus vrai si l'on considère l'augmentation de la charge de travail. Le faible pouvoir discriminant des signes cliniques et des symptômes ainsi que des autres paramètres de la trypanosomiase africaine met en évidence la difficulté de mise en place d'une stratégie d'intégration efficiente en tant qu'outil diagnostique précoce. (Résumé d'auteur

Intensity-Based Registration of Freehand 3D Ultrasound and CT-scan Images of the Kidney

This paper presents a method to register a pre-operative Computed-Tomography (CT) volume to a sparse set of intra-operative Ultra-Sound (US) slices. In the context of percutaneous renal puncture, the aim is to transfer planning information to an intra-operative coordinate system. The spatial position of the US slices is measured by optically localizing a calibrated probe. Assuming the reproducibility of kidney motion during breathing, and no deformation of the organ, the method consists in optimizing a rigid 6 Degree Of Freedom (DOF) transform by evaluating at each step the similarity between the set of US images and the CT volume. The correlation between CT and US images being naturally rather poor, the images have been preprocessed in order to increase their similarity. Among the similarity measures formerly studied in the context of medical image registration, Correlation Ratio (CR) turned out to be one of the most accurate and appropriate, particularly with the chosen non-derivative minimization scheme, namely Powell-Brent's. The resulting matching transforms are compared to a standard rigid surface registration involving segmentation, regarding both accuracy and repeatability. The obtained results are presented and discussed

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

Rectal route in the 21st Century to treat children.

The rectal route can be considered a good alternative to the oral route for the paediatric population because these dosage forms are neither to be swallowed nor need to be taste-masked. Rectal forms can also be administered in an emergency to unconscious or vomiting children. Their manufacturing cost is low with excipients generally regarded as safe. Some new formulation strategies, including mucoadhesive gels and suppositories, were introduced to increase patient acceptability. Even if recent paediatric clinical studies have demonstrated the equivalence of the rectal route with others, in order to enable the use of this promising route for the treatment of children in the 21st Century, some effort should be focused on informing and educating parents and care givers. This review is the first ever to address all the aforementioned items, and to list all drugs used in paediatric rectal forms in literature and marketed products in developed countries

The journey towards elimination of gambiense human African trypanosomiasis: not far, nor easy

Considering the epidemic situation of gambiense human African trypanosomiasis (HAT) at the end of the twentieth century, the World Health Organization (WHO) and partners strengthened disease control and surveillance. Over the last 15 years, the activities implemented through the National Control Programmes have brought gambiense HAT under control and now its elimination is deemed as an achievable goal. In 2012, WHO targeted gambiense HAT for elimination as a public health problem by 2020. The final goal will be the sustainable disease elimination by 2030, defined as the interruption of the transmission of gambiense HAT. The elimination is considered feasible, because of the epidemiological vulnerability of the disease, the current state of control, the availability of strategies and tools and international commitment and political will. Integration of activities in the health system is needed to ensure the sustainability of the elimination. The development of user-friendly diagnostic and treatment tools will facilitate the integration process. Adequate funding is needed to implement activities, but also to support research that will make the elimination sustainable. A long-term commitment by donors is needed and ownership of the process by endemic countries is critica