期刊
IEEE TRANSACTIONS ON MEDICAL IMAGING
卷 32, 期 7, 页码 1215-1226出版社
IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/TMI.2013.2243464
关键词
Cone-beam computed tomography (CBCT); endoscopy; image-guided treatment; registration; surgical guidance/navigation
类别
资金
- National Institutes of Health [R01-CA127444]
- NSF ERC [EEC9731748]
- Link Fellowship in Simulation and Training
- Medtronic Computer-Aided Surgery Research Award
The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) or, more recently, intraoperative cone-beam CT (CBCT). The ability to register real-time endoscopic video with CBCT offers an additional advantage by rendering information directly within the visual scene to account for intraoperative anatomical change. However, tracker localization error (similar to 1-2 mm) limits the accuracy with which video and tomographic images can be registered. This paper reports the first implementation of image-based video-CBCT registration, conducts a detailed quantitation of the dependence of registration accuracy on system parameters, and demonstrates improvement in registration accuracy achieved by the image-based approach. Performance was evaluated as a function of parameters intrinsic to the image-based approach, including system geometry, CBCT image quality, and computational runtime. Overall system performance was evaluated in a cadaver study simulating transsphenoidal skull base tumor excision. Results demonstrated significant improvement (p < 0.001) in registration accuracy with a mean reprojection distance error of 1.28 mm for the image-based approach versus 1.82 mm for the conventional tracker-based method. Image-based registration was highly robust against CBCT image quality factors of noise and resolution, permitting integration with low-dose intraoperative CBCT.
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