2D–3D radiograph to cone-beam computed tomography (CBCT) registration for C-arm image-guided robotic surgery

Abstract

Purpose C-arm radiographs are commonly used for intraoperative image guidance in surgical interventions. Fluoroscopy is a cost-effective real-time modality, although image quality can vary greatly depending on the target anatomy. Cone-beam computed tomography (CBCT) scans are sometimes available, so 2D–3D registration is needed for intra-procedural guidance. C-arm radiographs were registered to CBCT scans and used for 3D localization of peritumor fiducials during a minimally invasive thoracic intervention with a da Vinci Si robot. Methods Intensity-based 2D–3D registration of intraoperative radiographs to CBCT was performed. The feasible range of X-ray projections achievable by a C-arm positioned around a da Vinci Si surgical robot, configured for robotic wedge resection, was determined using phantom models. Experiments were conducted on synthetic phantoms and animals imaged with an OEC 9600 and a Siemens Artis zeego, representing the spectrum of different C-arm systems currently available for clinical use. Results The image guidance workflow was feasible using either an optically tracked OEC 9600 or a Siemens Artis zeego C-arm, resulting in an angular difference of Δθ : ~ 30°. The two C-arm systems provided TREmean ≤ 2.5 mm and TREmean ≤ 2.0 mm, respectively (i.e., comparable to standard clinical intraoperative navigation systems). Conclusions C-arm 3D localization from dual 2D–3D registered radiographs was feasible and applicable for intraoperative image guidance during da Vinci robotic thoracic interventions using the proposed workflow. Tissue deformation and in vivo experiments are required before clinical evaluation of this system.

Slot‐scan dual‐energy bone densitometry using motorized X‐ray systems

“…Future development of the proposed slot‐scan densitometry might involve translating this capability to certain embodiments of Cone‐Beam CT (CBCT) that enable linear scans in addition to conventional circular orbits—in particular, the fully robotized intraoperative C‐arms, such as Siemens Artis Zeego 61–63 and enclosed gantry systems with mechanisms for longitudinal gantry motion, like the Medtronic O‐arm 64 . In fact, slot‐scan imaging with a maximum translation speed of 3 cm/s has recently been demonstrated on the O‐arm 64 .…”

Cone‐beam imaging with tilted rotation axis: Method and performance evaluation

“…The robotic x-ray systems, whereby the x-ray tube and the detector are moved by robotized arms instead of a fixed gantry, have the capability to execute customized imaging trajectories. Such systems are increasingly common in interventional applications (e.g., Siemens Artis Zeego 15,[15][16][17][18] ), enabling noncircular CBCT orbits that have been shown to improve the visualization of specific tasks, 15 extend the field-of-view (FOV), 19 and reduce artifacts. 20 Robotic x-ray platforms are also being introduced for diagnostic imaging.…”

Automatic Lumbar Vertebrae Detection Based on Feature Fusion Deep Learning for Partial Occluded C-arm X-ray Images

“…Intraoperative mobile C-arm was wildly used in imageguided minimally invasive spine surgery (IG-MISS) due to providing up-to-date visualization of anatomy and surgical instruments [1]. C-arm images become connections between preoperative planning [2] and intraoperative navigation [3]. However, 2D C-arm X-ray images lack 3D spatial information, which can make surgeons fail to identify the spinal anatomy [4].…”