Endoscope Video Registration to Intra-operative Cone-Beam CT

Registration of endoscopic video to preoperative CT facilitates high-precision surgery of the head, neck, and skull-base. Conventional video-CT registration is limited by the accuracy of the tracker and does not use the underlying video or CT image data. In this project a image-based video registration method is developed to overcome the limitations of conventional tracker-based registration. This method adds to a navigation system based on intraoperative C-arm cone-beam CT (CBCT) that reflects anatomical change, in turn providing high-accuracy registration of video to the surgical scene. The resulting registration enables visualization of the CBCT and planning data within the endoscopic video. The system incorporates a mobile C-arm for high-performance CBCT, integrated with an optical tracking system, video endoscopy, deformable registration of preoperative CT with intraoperative CBCT, and 3D visualization. As in the tracker-based approach, in the image-based video-CBCT registration the endoscope is localized using an optical tracking system that provides a quick initialization followed by a direct 3D image-based registration of the video to the CBCT. In this way, the system achieves video-CBCT registration that is both fast and accurate.

Publications

  • A. Uneri, S. Schafer, D. J. Mirota, S. Nithiananthan, Y. Otake, R. H. Taylor, and J. H. Siewerdsen, "TREK: an integrated system architecture for intraoperative cone-beam CT-guided surgery," International Journal of Computer Assisted Radiology and Surgery, vol. 7, pp. 159-173, 2012.
    bibtex Go to document Go to document
    @ARTICLE{Uneri2012,
      author = {Uneri, A. and Schafer, S. and Mirota, D. J. and Nithiananthan, S. and Otake, Y. and Taylor, R. H. and Siewerdsen, J. H.},
      title = {TREK: an integrated system architecture for intraoperative cone-beam CT-guided surgery},
      journal = {International Journal of Computer Assisted Radiology and Surgery},
      year = {2012},
      volume = {7},
      pages = {159-173},
      abstract = {Purpose A system architecture has been developed for integration of intraoperative 3D imaging [viz., mobile C-arm cone-beam CT (CBCT)] with surgical navigation (e.g., trackers, endoscopy, and preoperative image and planning data). The goal of this paper is to describe the architecture and its handling of a broad variety of data sources in modular tool development for streamlined use of CBCT guidance in application-specific surgical scenarios. Methods The architecture builds on two proven open-source software packages, namely the cisst package (Johns Hopkins University, Baltimore, MD) and 3D Slicer (Brigham and Women's Hospital, Boston, MA), and combines data sources common to image-guided procedures with intraoperative 3D imaging. Integration at the software component level is achieved through language bindings to a scripting language (Python) and an object-oriented approach to abstract and simplify the use of devices with varying characteristics. The platform aims to minimize offline data processing and to expose quantitative tools that analyze and communicate factors of geometric precision online. Modular tools are defined to accomplish specific surgical tasks, demonstrated in three clinical scenarios (temporal bone, skull base, and spine surgery) that involve a progressively increased level of complexity in toolset requirements. Results The resulting architecture (referred to as "TREK") hosts a collection of modules developed according to application-specific surgical tasks, emphasizing streamlined integration with intraoperative CBCT. These include multi-modality image display; 3D-3D rigid and deformable registration to bring preoperative image and planning data to the most up-to-date CBCT; 3D-2D registration of planning and image data to real-time fluoroscopy; infrared, electromagnetic, and video-based trackers used individually or in hybrid arrangements; augmented overlay of image and planning data in endoscopic or in-room video; and real-time "virtual fluoroscopy" computed from GPU-accelerated digitally reconstructed radiographs (DRRs). Application in three preclinical scenarios (temporal bone, skull base, and spine surgery) demonstrates the utility of the modular, task-specific approach in progressively complex tasks. Conclusions The design and development of a system architecture for image-guided surgery has been reported, demonstrating enhanced utilization of intraoperative CBCT in surgical applications with vastly different requirements. The system integrates C-arm CBCT with a broad variety of data sources in a modular fashion that streamlines the interface to application-specific tools, accommodates distinct workflow scenarios, and accelerates testing and translation of novel toolsets to clinical use. The modular architecture was shown to adapt to and satisfy the requirements of distinct surgical scenarios from a common code-base, leveraging software components arising from over a decade of effort within the imaging and computer-assisted interventions community.},
      affiliation = {Department of Computer Science, Johns Hopkins University, Traylor Building, Room #726, 720 Rutland Avenue, Baltimore, MD 21205-2109, USA},
      doi = {10.1007/s11548-011-0636-7},
      file = {:Uneri2012.pdf:PDF},
      issn = {1861-6410},
      issue = {1},
      keyword = {Medicine},
      owner = {dmirota},
      publisher = {Springer Berlin / Heidelberg},
      timestamp = {2012.01.11},
      url = {http://dx.doi.org/10.1007/s11548-011-0636-7}
    }
  • S. Schafer, S. Nithiananthan, D. J. Mirota, A. Uneri, J. W. Stayman, W. Zbijewski, C. Schmidgunst, G. Kleinszig, A. J. Khanna, and J. H. Siewerdsen, "Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance," Medical Physics, vol. 38, iss. 8, pp. 4563-4574, 2011.
    bibtex Go to document Go to document
    @ARTICLE{Schafer2011,
      author = {S. Schafer and S. Nithiananthan and D. J. Mirota and A. Uneri and J. W. Stayman and W. Zbijewski and C. Schmidgunst and G. Kleinszig and A. J. Khanna and J. H. Siewerdsen},
      title = {Mobile C-arm cone-beam CT for guidance of spine surgery: Image quality, radiation dose, and integration with interventional guidance},
      journal = {Medical Physics},
      year = {2011},
      volume = {38},
      pages = {4563-4574},
      number = {8},
      doi = {10.1118/1.3597566},
      file = {:Schafer2011.pdf:PDF},
      keywords = {biomedical equipment; bone; computerised tomography; diagnostic radiography; dosimetry; orthopaedics; surgery},
      owner = {dmirota},
      publisher = {AAPM},
      timestamp = {2011.11.26},
      url = {http://link.aip.org/link/?MPH/38/4563/1}
    }
  • S. Nithiananthan, S. Schafer, A. Uneri, D. J. Mirota, W. J. Stayman, W. Zbijewski, K. K. Brock, M. J. Daly, H. Chan, J. C. Irish, and J. H. Siewerdsen, "Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach," Medical Physics, vol. 38, iss. 4, pp. 1785-1798, 2011.
    bibtex Go to document Go to document
    @ARTICLE{Nithiananthan2011,
      author = {Sajendra Nithiananthan and Sebastian Schafer and Ali Uneri and Daniel J. Mirota and J. Webster Stayman and Wojciech Zbijewski and Kristy K. Brock and Michael J. Daly and Harley Chan and Jonathan C. Irish and Jeffrey H. Siewerdsen},
      title = {Demons deformable registration of CT and cone-beam CT using an iterative intensity matching approach},
      journal = {Medical Physics},
      year = {2011},
      volume = {38},
      pages = {1785-1798},
      number = {4},
      doi = {10.1118/1.3555037},
      file = {:Nithiananthan2011.pdf:PDF},
      keywords = {computerised tomography; image reconstruction; image registration; iterative methods; medical image processing; X-ray scattering},
      owner = {dmirota},
      publisher = {AAPM},
      timestamp = {2011.06.07},
      url = {http://link.aip.org/link/?MPH/38/1785/1}
    }
  • A. Uneri, S. Schafer, D. Mirota, S. Nithiananthan, Y. Otake, S. Reaungamornrat, J. Yoo, W. J. Stayman, D. Reh, G. L. Gallia, J. A. Khanna, G. Hager, R. H. Taylor, G. Kleinszig, and J. H. Siewerdsen, "Architecture of a high-performance surgical guidance system based on C-arm cone-beam CT: software platform for technical integration and clinical translation," in Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling, 2011, pp. 796422‑1-796422‑7.
    bibtex Go to document Go to document
    @CONFERENCE{Uneri2011,
      author = {Ali Uneri and Sebastian Schafer and Daniel Mirota and Sajendra Nithiananthan and Yoshito Otake and Sureerat Reaungamornrat and Jongheun Yoo and J. Webster Stayman and Douglas Reh and Gary L. Gallia and A. Jay Khanna and Gregory Hager and Russell H. Taylor and Gerhard Kleinszig and Jeffrey H. Siewerdsen},
      title = {Architecture of a high-performance surgical guidance system based on C-arm cone-beam CT: software platform for technical integration and clinical translation},
      booktitle = {Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling},
      year = {2011},
      editor = {Kenneth H. Wong and David R. Holmes III},
      volume = {7964},
      number = {1},
      pages = {796422‑1 -- 796422‑7},
      publisher = {SPIE},
      doi = {10.1117/12.878191},
      eid = {796422},
      file = {:Uneri2011.pdf:PDF},
      journal = {Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling},
      location = {Lake Buena Vista, Florida, USA},
      numpages = {7},
      owner = {dmirota},
      timestamp = {2010.07.31},
      url = {http://link.aip.org/link/?PSI/7964/796422/1}
    }
  • D. J. Mirota, A. Uneri, S. Schafer, S. Nithiananthan, D. D. Reh, G. L. Gallia, R. H. Taylor, G. D. Hager, and J. H. Siewerdsen, "High-accuracy 3D image-based registration of endoscopic video to C-arm cone-beam CT for image-guided skull base surgery," in Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling, 2011, pp. 79640j‑1-79640j‑10.
    bibtex Go to document Go to document
    @CONFERENCE{Mirota2011,
      author = {Daniel J. Mirota and Ali Uneri and Sebastian Schafer and Sajendra Nithiananthan and Douglas D. Reh and Gary L. Gallia and Russell H. Taylor and Gregory D. Hager and Jeffrey H. Siewerdsen},
      title = {High-accuracy 3D image-based registration of endoscopic video to C-arm cone-beam CT for image-guided skull base surgery},
      booktitle = {Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling},
      year = {2011},
      editor = {Kenneth H. Wong and David R. Holmes III},
      volume = {7964},
      number = {1},
      pages = {79640J‑1 - 79640J‑10},
      publisher = {SPIE},
      doi = {10.1117/12.877803},
      eid = {79640J},
      file = {:Mirota2011.pdf:PDF},
      fundingagency = {NIH},
      journal = {Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling},
      location = {Lake Buena Vista, Florida, USA},
      numpages = {10},
      owner = {dmirota},
      timestamp = {2011.02.21},
      url = {http://link.aip.org/link/?PSI/7964/79640J/1}
    }