Recent technological advancements in medical imaging equipment have resulted in
a dramatic improvement of image accuracy, now capable of providing useful information
previously not available to clinicians. In the surgical context, intraoperative
imaging provides a crucial value for the success of the operation.
Many nontrivial scientific and technical problems need to be addressed in order to
efficiently exploit the different information sources nowadays available in advanced
operating rooms. In particular, it is necessary to provide: (i) accurate tracking of
surgical instruments, (ii) real-time matching of images from different modalities, and
(iii) reliable guidance toward the surgical target. Satisfying all of these requisites
is needed to realize effective intraoperative navigation systems for image-guided
surgery.
Various solutions have been proposed and successfully tested in the field of image
navigation systems in the last ten years; nevertheless several problems still arise in
most of the applications regarding precision, usability and capabilities of the existing
systems. Identifying and solving these issues represents an urgent scientific challenge.
This thesis investigates the current state of the art in the field of intraoperative
navigation systems, focusing in particular on the challenges related to efficient and
effective usage of ultrasound imaging during surgery.
The main contribution of this thesis to the state of the art are related to:
Techniques for automatic motion compensation and therapy monitoring applied
to a novel ultrasound-guided surgical robotic platform in the context of
abdominal tumor thermoablation.
Novel image-fusion based navigation systems for ultrasound-guided neurosurgery
in the context of brain tumor resection, highlighting their applicability
as off-line surgical training instruments.
The proposed systems, which were designed and developed in the framework of
two international research projects, have been tested in real or simulated surgical
scenarios, showing promising results toward their application in clinical practice