Pose-aware C-arm for automatic re-initialization of interventional 2D/3D image registration

Abstract

Purpose In minimally invasive interventions assisted by C-arm imaging, there is a demand to fuse the intra-interventional 2D C-arm image with pre-interventional 3D patient data to enable surgical guidance. The commonly used intensity-based 2D/3D registration has a limited capture range and is sensitive to initialization. We propose to utilize an opto/X-ray C-arm system which allows to maintain the registration during intervention by automating the re-initialization for the 2D/3D image registration. Consequently, the surgical workflow is not disrupted and the interaction time for manual initialization is eliminated. Methods We utilize two distinct vision-based tracking techniques to estimate the relative poses between different C-arm arrangements: (1) global tracking using fused depth information and (2) RGBD SLAM system for surgical scene tracking. A highly accurate multi-view calibration between RGBD and C-arm imaging devices is achieved using a custom-made multimodal calibration target. Results Several in vitro studies are conducted on pelvic-femur phantom that is encased in gelatin and covered with drapes to simulate a clinically realistic scenario. The mean target registration errors (mTRE) for re-initialization using depth-only and RGB+depth are 13.23mm and 11.81mm, respectively. 2D/3D registration yielded 75% success rate using this automatic re-initialization, compared to a random initialization which yielded only 23% successful registration. Conclusion The pose-aware C-arm contributes to the 2D/3D registration process by globally re-initializing the relationship of C-arm image and pre-interventional CT data. This system performs inside-out tracking, is self-contained, and does not require any external tracking devices.

Augmented reality‐based feedback for technician‐in‐the‐loop C‐arm repositioning

“…In contrast to previous methods [ 8 , 12 , 13 ], our approach can be directly deployed in the operating theatre without any preparation of the environment or assumptions on the procedure. This translates to two immediate benefits: First, our method does not require pre- or intra-operative 3D imaging, and therefore, circumvents intra-operative 3D/2D registration, a major challenge in clinical deployment [ 17 , 18 ]. Second, there is no need for additional markers and external trackers as in Matthews [ 14 ] or access to internal encoders of the C-arm as in De Silva [ 8 ].…”

Plan in 2-D, execute in 3-D: an augmented reality solution for cup placement in total hip arthroplasty

“…All surgeons participating in the user study believed that presetting the cup orientation is useful and valid, as having access to AP images in the OR is a well-founded assumption. Nonetheless, the authors believe that a pose-aware RGBD augmented C-arm 52 can, in future, assist the surgeon in acquiring and confirming true AP images considering pelvis supine tilts in different planes. 27 These results show the clear necessity to continue research and perform user studies on cadaveric specimens and quantify the changes in operating time, number of required X-ray images, dose, accuracy, and surgical task load compared to classic image-guided approaches.…”

Research on the accuracy of three‐dimensional localization and navigation in robot‐assisted spine surgery

“…The X-ray images taken by C-arm machine have some distortion such as s-shape distortion, pillow distortion, and local distortion. 32,33 Therefore, all X-ray images taken with C-arm need to be corrected with calibration target. The designed calibration target was shown in Figure 5.…”