Abstract. This paper presents a method to register a preoperative CT volume to a sparse set of intraoperative US slices. In the context of percutaneous renal puncture, the aim is to transfer a planning information to an intraoperative coordinate system. The spatial position of the US slices is measured by localizing a calibrated probe. Our method consists in optimizing a rigid 6 degree of freedom (DOF) transform by evaluating at each step the similarity between the set of US images and the CT volume. The images have been preprocessed in order to increase the relationship between CT and US pixels. Correlation Ratio turned out to be the most accurate and appropriate similarity measure to be used in a Powell-Brent minimization scheme. Results are compared to a standard rigid point-to-point registration involving segmentation, and discussed.
Our system is reliable, and the absence of image-processing procedures makes it robust. We have initiated a prospective study to validate this technique both for PCNL specialists and as a learning tool.
Until recently, Computer-Aided Medical Interventions (CAMI) and Medical Robotics have focused on rigid and non deformable anatomical structures. Nowadays, special attention is paid to soft tissues, raising complex issues due to their mobility and deformation. Miniinvasive digestive surgery was probably one of the first fields where soft tissues were handled through the development of simulators, tracking of anatomical structures and specific assistance robots. However, other clinical domains, for instance urology, are concerned.Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU, radiofrequency, or cryoablation), increasingly early detection of cancer, and use of interventional and diagnostic imaging modalities, recently opened new challenges to the urologist and scientists involved in CAMI. This resulted in the last five years in a very significant increase of research and developments of computer-aided urology systems. In this paper, we propose a description of the main problems related to computer-aided diagnostic and therapy of soft tissues and give a survey of the different types of assistance offered to the urologist: robotization, image fusion, surgical navigation. Both research projects and operational industrial systems are discussed.
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