Soft Tissue Monitoring of the Surgical Field: Detection and Tracking of Breast Surface Deformations

Richey, Winona L.; Heiselman, Jon S.; Ringel, Morgan J.; Meszoely, Ingrid M.; Miga, Michael I.

doi:10.1109/tbme.2022.3233909

Cited by 5 publications

(13 citation statements)

References 42 publications

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“…With respect to sources of error, the resolution of feature points in the stereo camera pair (Figure 5) relies on image processing methods to reliably extract features. This accuracy has been reported to be approximately 1.6mm on average [11]. In addition, point localization with the NDI tracked stylus is subject to approximately 1.0mm of localization error.…”

Section: Discussionmentioning

confidence: 92%

“…Then, without adjusting or moving the cart setup, stereo camera images of the breast phantom were collected from each of the two Grasshopper cameras, and the fiducials on the breast phantom were digitized with the tracked NDI stylus. Using a custom MATLAB program, the fiducial coordinates from the stereo camera images were triangulated in stereo camera space [11]. The stereo camera points were then registered to NDI camera space using the calibration output data, and a TRE between the transformed stereo camera pair points and the collected NDI points was determined.…”

Section: Experimental Designmentioning

confidence: 99%

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Stereovision registration using a tracked checkerboard calibration object for a breast surgery image guidance system

Stabile

Ringel

Richey

et al. 2023

Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling

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Breast cancer is a leading cause of death among women in the United States, and breast conserving surgery (BCS) is a common treatment option for women with early-stage breast cancer. The goal of BCS is to localize and remove the tumor with negative margins, and incomplete tumor excision can lead to reoperation and recurrence. To aid with intraoperative tumor localization, a BCS image guidance system that features an optical tracking camera (NDI Polaris Vicra) and stereocameras (FLIR Grasshopper stereocamera pair) for tracking surgical tools and surgical scene monitoring, respectively, is being investigated. However, sensor data collected from both stereovision systems are not inherently coregistered. Thus, this paper proposes utilizing a tracked checkerboard calibration object paired with a custom 3DSlicer module for optical tracker and stereo camera co-registration. The module features an easy-to-use user interface to streamline calibration. The calibration process was validated with a tissue-mimicking breast phantom embedded with beads to represent surface fiducials and undergoing deformations (n=5 mock phantom tissue states). Across five independent calibration trials, the average fiducial registration error (FRE) was calculated to be 0.68mm ± 0.11mm while the average target registration error (TRE) was calculated to be 0.35mm ± 0.14mm. With respect to the challenge test conditions using the mock breast phantom under differing deformations, TRE values were on average determined to be 2.58mm ± 0.26mm over all breast phantom states. Thus, a tracked checkerboard tool paired with the custom 3DSlicer module provided the ability to localize and track points of interest for accurate registration of two different optical tracking systems.

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Section: Discussionmentioning

confidence: 92%

Section: Experimental Designmentioning

confidence: 99%

Stereovision registration using a tracked checkerboard calibration object for a breast surgery image guidance system

Stabile

Ringel

Richey

et al. 2023

Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling

Self Cite

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“…The phantom shape was modeled after the Breast Probe Model for breast ultrasound training from Simulab (Simulab Corporation, Seattle, WA, USA). 26 red-ink fiducial markers were placed on the phantom surface to mimic skin fiducials that have been proposed for skin surface tracking in previous work 6 . These red-ink fiducials were placed on top of red glass beads so that they were visible in stereo camera imaging and CT imaging.…”

Section: Phantom Experimentsmentioning

confidence: 99%

“…Alternatively, monitoring the surgical field to capture breast shape changes and then using that data to inform deformable registration algorithms could be a workflow-friendly means to establish image guidance for BCS. Previous work focused on a technique for achieving this by measuring the breast geometry with stereo camera monitoring and ink-based surface fiducials 6 . Inked fiducial points and alphabetic letters were written on the breast surface and matched with labeled points in an MR image.…”

Section: Introductionmentioning

confidence: 99%

Image guidance system for breast conserving surgery with integrated stereo camera monitoring and deformable correction

Ringel,

Richey,

Heiselman

et al. 2024

Medical Imaging 2024: Image-Guided Procedures, Robotic Interventions, and Modeling

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Breast conserving surgery (BCS) is a common treatment option for women with early-stage breast cancer, but these procedures have high and variable reoperation rates due to positive margins. Current tumor localization technologies do not provide real-time spatial information about the tumor boundary, emphasizing the need for additional navigation tools. This work proposes an image-guidance system for BCS that combines stereo camera soft tissue monitoring with nonrigid registration to account for misalignments from soft-tissue deformations. The guidance system integrates an optical tracking sensor and a 3D stereo-camera sensor for surgical field monitoring. A custom user interface and display, developed using 3D Slicer, facilitates data collection and visualization of patient-specific imaging data and models. Near real-time deformable correction is driven by tissue displacement measurements and compensates for breast shape change. The feasibility and effectiveness of the guidance system are demonstrated through breast phantom deformation experiments that simulated tissue deformations. In 4 deformation states, 3D stereo-camera sensor data is collected, and imaging data is deformed in near real-time. Evaluation results show a reduction in fiducial and surface registration errors after deformable correction compared to conventional rigid registration approaches. The guidance system is then demonstrated on a healthy volunteer, where data collection and nonrigid correction are performed in a mock intraoperative setting. Overall, the proposed system achieved data collection and navigation capabilities compatible with current BCS workflows. However, quantitatively measuring navigation accuracy and clinical value is not addressed here and should be the focus of future work.

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“…To simulate the deformations that occur during BCS procedures due to retraction, a breast silicone phantom was developed. The phantom was constructed from 75% Ecoflex 00-10 platinum cure silicone rubber, 12.5% silicone rubber thinning fluid (Silicone Thinner), and 12.5% tactile mutator (Slacker) from Smooth-On, Inc. To quantify surface deformations, 26 1mm red glass beads were embedded on the phantom surface to simulate the typical sparse data acquisition achievable in previous studies 11 . In addition, 30 1-mm yellow glass beads were distributed throughout the subsurface phantom tissue.…”

Section: Phantom Developmentmentioning

confidence: 99%

Modeling retraction for breast conserving surgery guidance

Espinosa

Ringel

Heiselman

et al. 2023

Medical Imaging 2023: Image-Guided Procedures, Robotic Interventions, and Modeling

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Breast conserving surgery is a common treatment option for early-stage breast cancer, and it relies on complete tumor excision such that no residual cancer is left in the resection cavity. However, the use of preoperative imaging to inform excision is compromised by intraoperative deformations that change the location, volume, and shape of the tumor compared to the imaging configuration. For intra-procedural guidance specifically, incision and retraction alter the tumor presentation and geometry. Being able to compensate for retraction deformations intraoperatively may increase the utility of image guidance technologies. In this work, a breast retraction phantom and deformation modeling approach are developed to explore the potential of modeling retraction for image guidance during BCS. Surface and subsurface beads were embedded in a realistic silicone breast phantom, and CT images were acquired in undeformed and retracted states. A reconstructive, sparse-data registration method was used to model retraction. Modeling accuracy was evaluated by comparing model-predicted and ground-truth bead displacements. The average surface bead registration error after retraction modeling in a region of interest was 0.5 ± 0.1 mm (maximum 0.5 mm). The average subsurface bead registration error in a region of interest was 1.2 ± 0.6 mm (maximum 2.6 mm). A biomechanical modeling method that includes retraction may improve the accuracy of image guidance for breast conserving surgery, but more work is needed to evaluate its utility.

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Soft Tissue Monitoring of the Surgical Field: Detection and Tracking of Breast Surface Deformations

Cited by 5 publications

References 42 publications

Stereovision registration using a tracked checkerboard calibration object for a breast surgery image guidance system

Stereovision registration using a tracked checkerboard calibration object for a breast surgery image guidance system

Image guidance system for breast conserving surgery with integrated stereo camera monitoring and deformable correction

Modeling retraction for breast conserving surgery guidance

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