Intraoperative use of cone‐beam computed tomography in a cadaveric ossified cochlea model

Barker, Emma; Trimble, Keith; Chan, Harley; Ramsden, James D.; Nithiananthan, Sajendra; James, Arthur G.; Bachar, Gideon; Daly, Mike; Irish, Jonathan C.; Siewerdsen, J. H.

doi:10.1016/j.otohns.2008.12.046

Cited by 37 publications

(25 citation statements)

References 23 publications

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“…15 Nominal 3D volumes encompass ∼20 × 20 × 15 cm 3 with isotropic 0.8-mm 3 voxels, and are reconstructed within ∼15 seconds of scan completion (∼1-minute acquisition). The CBCT imaging platform has undergone extensive investigation in preclinical head and neck 7 and otology, 8 and is currently deployed in a prospective clinical trial in head and neck surgery.…”

Section: Methodsmentioning

confidence: 99%

“…6 Recent advances in intraoperative cone-beam CT (CBCT) have allowed for the integration of updated 3-dimensional (3D) images to these systems, providing the surgeon with radiological data reflecting excised tissue and anatomical deformation in the context of a dynamic surgical field. 7,8 Image-guided surgery with updated intraoperative CBCT images has also been shown to aid in landmark identification for surgeons in training. 9 The emerging role of these intraoperative imaging systems motivates the development of accurate methods to register 3D imaging with endoscopic video, to potentially provide improved visualization of anatomical structures beyond the visible surgical surface.…”

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confidence: 99%

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Real‐time tracking and virtual endoscopy in cone‐beam CT‐guided surgery of the sinuses and skull base in a cadaver model

Prisman

Daly

Chan

et al. 2011

Int Forum Allergy Rhinol

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Real‐time tracking and virtual endoscopy in cone‐beam CT‐guided surgery of the sinuses and skull base in a cadaver model

Prisman

Daly

Chan

et al. 2011

Int Forum Allergy Rhinol

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“…Previous work in the context of spine and skull base surgery have demonstrated the utility of such application-specific modules for early translational research in seeing CBCT guidance from the laboratory to early clinical studies. 9,57,58 In CBCT-guided surgery, such modules will encompass not only the deformable registration approach described above (possibly including simplified forms for scenarios appropriate to model-only and model + image-driven approaches) but also integration of the registered data with thoracoscopic video for accurate real-time overlay of registered planning data directly on the thoracoscopic scene. 10 …”

Section: Discussionmentioning

confidence: 99%

Deformable registration of the inflated and deflated lung in cone‐beam CT‐guided thoracic surgery: Initial investigation of a combined model‐ and image‐driven approach

et al. 2012

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Purpose: Surgical resection is the preferred modality for curative treatment of early stage lung cancer, but localization of small tumors (<10 mm diameter) during surgery presents a major challenge that is likely to increase as more early-stage disease is detected incidentally and in low-dose CT screening. To overcome the difficulty of manual localization (fingers inserted through intercostal ports) and the cost, logistics, and morbidity of preoperative tagging (coil or dye placement under CT-fluoroscopy), the authors propose the use of intraoperative cone-beam CT (CBCT) and deformable image registration to guide targeting of small tumors in video-assisted thoracic surgery (VATS). A novel algorithm is reported for registration of the lung from its inflated state (prior to pleural breach) to the deflated state (during resection) to localize surgical targets and adjacent critical anatomy. Methods: The registration approach geometrically resolves images of the inflated and deflated lung using a coarse model-driven stage followed by a finer image-driven stage. The model-driven stage uses image features derived from the lung surfaces and airways: triangular surface meshes are morphed to capture bulk motion; concurrently, the airways generate graph structures from which corresponding nodes are identified. Interpolation of the sparse motion fields computed from the bounding surface and interior airways provides a 3D motion field that coarsely registers the lung and initializes the subsequent image-driven stage. The image-driven stage employs an intensity-corrected, symmetric form of the Demons method. The algorithm was validated over 12 datasets, obtained from porcine specimen experiments emulating CBCT-guided VATS. Geometric accuracy was quantified in terms of target registration error (TRE) in anatomical targets throughout the lung, and normalized crosscorrelation. Variations of the algorithm were investigated to study the behavior of the model-and image-driven stages by modifying individual algorithmic steps and examining the effect in comparison to the nominal process. Results: The combined model-and image-driven registration process demonstrated accuracy consistent with the requirements of minimally invasive VATS in both target localization (∼3-5 mm within the target wedge) and critical structure avoidance (∼1-2 mm). The model-driven stage initialized the registration to within a median TRE of 1.9 mm (95% confidence interval (CI) maximum = 5.0 mm), while the subsequent image-driven stage yielded higher accuracy localization with 0.6 mm median TRE (95% CI maximum = 4.1 mm). The variations assessing the individual algorithmic steps elucidated the role of each step and in some cases identified opportunities for further simplification and improvement in computational speed. Conclusions:The initial studies show the proposed registration method to successfully register CBCT images of the inflated and deflated lung. Accuracy appears sufficient to localize the target and adjacent critical anatomy within ∼1-2 mm and guide ...

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“…While studies have shown efficacy in using both multi-slice CT [3] and flat-panel-based cone-beam CT (CBCT) [4], cochlear implant imaging remains difficult due to reconstruction artifacts, often making visualization of individual electrodes or the surrounding anatomy troublesome. Better visualization of the implant and surrounding anatomy would benefit postoperative assessment and help to facilitate minimally invasive procedures[5], potentially with intraoperative CBCT [6] for immediate correction of misplaced implants. Cochlear implants, typically composed of platinum or platinum-iridium alloys, have important features that are often near the spatial resolution limits of the scanner and are subject to a number of effects that make them particularly susceptible to metal artifacts (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Overcoming nonlinear partial volume effects in known-component reconstruction of Cochlear implants

Stayman¹,

Dang

Otake

et al. 2013

Medical Imaging 2013: Physics of Medical Imaging

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Nonlinear partial volume (NLPV) effects can be significant for objects with large attenuation differences and fine detail structures near the spatial resolution limits of a tomographic system. This is particularly true for small metal devices like cochlear implants. While traditional model-based approaches might alleviate these artifacts through very fine sampling of the image volume and subsampling of rays to each detector element, such solutions can be extremely burdensome in terms of memory and computational requirements. The work presented in this paper leverages the model-based approach called “known-component reconstruction” (KCR) where prior knowledge of a surgical device is integrated into the estimation. In KCR, the parameterization of the object separates the volume into an unknown background anatomy and a known component with unknown registration. Thus, one can model projections of an implant at very high spatial resolution while limiting the spatial resolution of the anatomy - in effect, modeling NLPV effects where they are most significant. We present modifications of the KCR approach that can be used to largely eliminate NLPV artifacts, and demonstrate the efficacy of the modified technique (with improved image quality and accurate implant position estimates) for the cochlear implant imaging scenario.

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Intraoperative use of cone‐beam computed tomography in a cadaveric ossified cochlea model

Cited by 37 publications

References 23 publications

Real‐time tracking and virtual endoscopy in cone‐beam CT‐guided surgery of the sinuses and skull base in a cadaver model

Real‐time tracking and virtual endoscopy in cone‐beam CT‐guided surgery of the sinuses and skull base in a cadaver model

Deformable registration of the inflated and deflated lung in cone‐beam CT‐guided thoracic surgery: Initial investigation of a combined model‐ and image‐driven approach

Overcoming nonlinear partial volume effects in known-component reconstruction of Cochlear implants

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