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8 March 2019 Image fusion on the endoscopic view for endo-nasal skull-base surgery
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The use of pre-operative CT and MR images for navigation during endo-nasal skull-base endoscopic surgery is a well-established procedure in clinical practice. Fusion of CT and MR images on the endoscopic view can offer an additional advantage by directly overlaying surgical-planning information in the surgical view. Fusion of intraoperative images, such as cone beam computed tomography (CBCT), represents a step forward since these images can also account for intra-operative anatomical changes. In this work, we present a method for intra-operative CBCT image fusion on the endoscopic view for endo-nasal skull-base surgery, implemented on the Philips surgical navigation system. This is the first study which utilizes an optical tracking system (OTS) embedded in the flat-panel detector of the C-arm for endoscopic-image augmentation. In our method the OTS, co-registered in the same CBCT coordinate system, is used for tracking the endoscope. Accuracy in CBCT image registration in the endoscopic view is studied using a calibration board. Image fusion is tested in a realistic surgical scenario by using a skull phantom and inserts that mimic critical structures at the skull base. Overall performances tested on the skull phantom show a high accuracy in tracking the endoscope and registration of CBCT on endoscopic view. It can be concluded that the implemented system show potential for usage in endo-nasal skull-base surgery.
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Marco Lai, Caifeng Shan, Drazenko Babic, Robert Homan, Adrian Elmi Terander, Erik Edstrom, Oscar Persson, Gustav Burstrom, and Peter H. N. de With "Image fusion on the endoscopic view for endo-nasal skull-base surgery", Proc. SPIE 10951, Medical Imaging 2019: Image-Guided Procedures, Robotic Interventions, and Modeling, 109511D (8 March 2019);

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