31 March 2008 From pre-operative cardiac modeling to intra-operative virtual environments for surgical guidance: an in vivo study
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Abstract
As part of an ongoing theme in our laboratory on reducing morbidity during minimally-invasive intracardiac procedures, we developed a computer-assisted intervention system that provides safe access inside the beating heart and sufficient visualization to deliver therapy to intracardiac targets while maintaining the efficacy of the procedure. Integrating pre-operative information, 2D trans-esophageal ultrasound for real-time intra-operative imaging, and surgical tool tracking using the NDI Aurora magnetic tracking system in an augmented virtual environment, our system allows the surgeons to navigate instruments inside the heart in spite of the lack of direct target visualization. This work focuses on further enhancing intracardiac visualization and navigation by supplying the surgeons with detailed 3D dynamic cardiac models constructed from high-resolution pre-operative MR data and overlaid onto the intra-operative imaging environment. Here we report our experience during an in vivo porcine study. A feature-based registration technique previously explored and validated in our laboratory was employed for the pre-operative to intra-operative mapping. This registration method is suitable for in vivo interventional applications as it involves the selection of easily identifiable landmarks, while ensuring a good alignment of the pre-operative and intra-operative surgical targets. The resulting augmented reality environment fuses the pre-operative cardiac model with the intra-operative real-time US images with approximately 5 mm accuracy for structures located in the vicinity of the valvular region. Therefore, we strongly believe that our augmented virtual environment significantly enhances intracardiac navigation of surgical instruments, while on-target detailed manipulations are performed under real-time US guidance.
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Cristian A. Linte, Cristian A. Linte, Marcin Wierzbicki, Marcin Wierzbicki, John Moore, John Moore, Christopher Wedlake, Christopher Wedlake, Andrew D. Wiles, Andrew D. Wiles, Daniel Bainbridge, Daniel Bainbridge, Gérard M. Guiraudon, Gérard M. Guiraudon, Douglas L Jones, Douglas L Jones, Terry M. Peters, Terry M. Peters, } "From pre-operative cardiac modeling to intra-operative virtual environments for surgical guidance: an in vivo study", Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling, 69180D (31 March 2008); doi: 10.1117/12.772028; https://doi.org/10.1117/12.772028
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