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Vergne C, Madec M, Guzman R, Pascal J, Taub E, Bourgeois F, Hemm S. In Vitro Assessment and Comparison of a Novel Electromagnetic Tracking System for Stereotactic DBS Surgery. Ann Biomed Eng 2025; 53:1512-1523. [PMID: 40208399 PMCID: PMC12075333 DOI: 10.1007/s10439-025-03728-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 03/28/2025] [Indexed: 04/11/2025]
Abstract
Real-time guidance for the implantation of deep-brain-stimulation (DBS) electrodes in the context of stereotactic neurosurgery is essential but currently unavailable. Electromagnetic tracking (EMT) systems offer high-accuracy localization of tools in restricted volumes but face compatibility issues with stereotactic procedures due to electromagnetic distortions. This paper aims to evaluate and compare the localization performance (position and orientation) of a novel EMT system, the ManaDBS, specifically designed for stereotactic surgical environments, against the NDI Aurora, a commercially available EMT system. Two studies were conducted to assess the suitability of each EMT system for stereotactic DBS surgery. The first study evaluated performance accuracy within the measurement volume in the presence of two different stereotactic systems (Frame G and Vantage system, Elekta). The second study simulated a DBS surgical theater, performing implantation procedures with each EMT system and evaluating the position accuracy of the EMT sensor. The localization errors of Aurora (0.66 mm and 0.89°) were lower to those of ManaDBS (1.57 mm and 1.01°). However, in the presence of a stereotactic system, Aurora exhibited notable degradation (2.34 mm and 1.03°), whereas ManaDBS remained unaffected. This pattern persisted during simulated implantation in a DBS surgical environment, where nonlinear trajectories with significant error fluctuations along the implantation path were observed with Aurora system. The significant electromagnetic-field distortions render the Aurora system incompatible for stereotactic DBS surgery. However, the ManaDBS system exhibited no impact from these distortions, suggesting its potential suitability for DBS surgery and other potential applications in stereotactic neurosurgery.
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Affiliation(s)
- Céline Vergne
- School of Life Sciences, Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland.
- ICube Laboratory, University of Strasbourg-CNRS, Strasbourg, France.
- Department of Biomedical Engineering, Faculty of Medicine, University Basel, Allschwil, Switzerland.
| | - Morgan Madec
- ICube Laboratory, University of Strasbourg-CNRS, Strasbourg, France
| | - Raphael Guzman
- Department of Biomedical Engineering, Faculty of Medicine, University Basel, Allschwil, Switzerland
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - Joris Pascal
- School of Life Sciences, Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Ethan Taub
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - Frédéric Bourgeois
- School of Life Sciences, Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Simone Hemm
- School of Life Sciences, Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
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Sun M, Rao L, Zhang C, Zhang P, Chai G. Analysis of influence of surgical instruments on accuracy of magnetic navigation system for craniofacial surgery robots. Comput Assist Surg (Abingdon) 2023; 28:2210744. [PMID: 37256777 DOI: 10.1080/24699322.2023.2210744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
IntroductionIn craniofacial surgery, magnetic navigation systems can effectively extend the doctor's limited visual range, improve their surgical precision, shorten the operation time, and reduce the incidence of surgical complications. Owing to the ease of magnetic navigation, the accuracy of the magnetic navigation system is affected by various equipment in the operating room. Therefore, its large-scale application is lacking because the navigation accuracy requirement can be extremely high during craniofacial surgery. Therefore, the accuracy of magnetic navigation systems is crucial. Various surgical instruments have been evaluated to effectively reduce the interference of magnetic navigation systems with surgical instruments. In craniofacial surgery, magnetic navigation systems can effectively extend the doctor's limited visual range, improve their surgical precision, shorten the operation time, and reduce the incidence of surgical complications. Owing to the ease of magnetic navigation, the accuracy of the magnetic navigation system is affected by various equipment in the operating room. Therefore, its large-scale application is lacking because the navigation accuracy requirement can be extremely high during craniofacial surgery. Therefore, the accuracy of magnetic navigation systems is crucial. Various surgical instruments have been evaluated to effectively reduce the interference of magnetic navigation systems with surgical instruments. In the surgical environment, the use of surgical instruments during mandibular surgery was simulated by selecting several conventional surgical instruments to record errors in the magnetic navigation system. The fluctuation values of the magnetic navigation errors were subsequently estimated and changes in its accuracy measured. MATLAB was used to calculate and analyze the fluctuations of the magnetic navigation errors. As results, the high-frequency electrosurgical system caused the greatest interference with the magnetic navigation system during surgery while powered on, with a maximum fluctuation error value of 1.8120 mm, and the maximum fluctuation error values of the stitch scissors, teeth forceps, and a needle holder were 1.3662, 1.3781, and 0.3912 mm, respectively. The closer the instrument is to the magnetic field generator or navigation target, the greater its impact. In conclusion, stitch scissors, teeth forceps, a needle holder, and the high-frequency electrosurgical system all affect magnetic navigation system accuracy. Therefore, it is necessary to avoid magnetic navigation system use and surgical instrument disturbances during surgery or select surgical instruments that do not interfere with the system. Surgical instruments must be evaluated for electromagnetic interference before they can be used in surgery with a magnetic navigation system.
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Affiliation(s)
- Mengzhe Sun
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lan Rao
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Cunliang Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Peiming Zhang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
- NMPA Key Laboratory for Respiratory and Anaesthetic Equipment, Shanghai, China
| | - Gang Chai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Krumb HJ, Dorweiler B, Mukhopadhyay A. HEX: a safe research framework for hybrid EMT X-ray navigation. Int J Comput Assist Radiol Surg 2023:10.1007/s11548-023-02917-y. [PMID: 37171661 PMCID: PMC10329580 DOI: 10.1007/s11548-023-02917-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/12/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Navigating with continuous X-ray provides visual guidance, but exposes both surgeon and patient to ionizing radiation, which is associated with serious health risks. Interleaving fluoro snapshots with electromagnetic tracking (EMT) potentially minimizes radiation. METHODS We propose hybrid EMT + X-ray (HEX), a research framework for navigation with an emphasis on safe experimentation. HEX is based on several hardware and software components that are orchestrated to allow for safe and efficient data acquisition. RESULTS In our study, hybrid navigation reduces radiation by [Formula: see text] with cubic, and by [Formula: see text] with linear error compensation while achieving submillimeter accuracy. Training points for compensation can be reduced by half while keeping a similar accuracy-radiation trade-off. CONCLUSION The HEX framework allows to safely and efficiently evaluate the hybrid navigation approach in simulated procedures. Complementing intraoperative X-ray with EMT significantly reduces radiation in the OR, increasing the safety of patients and surgeons.
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Affiliation(s)
- Henry J Krumb
- Computer Science Department, TU-Darmstadt, Fraunhoferstr. 5, 64283, Darmstadt, Germany.
| | | | - Anirban Mukhopadhyay
- Computer Science Department, TU-Darmstadt, Fraunhoferstr. 5, 64283, Darmstadt, Germany
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Zhang Z, Zhao Z, Han W, Kim BS, Yan Y, Chen X, Lin L, Shen W, Chai G. Accuracy and safety of robotic navigation-assisted distraction osteogenesis for hemifacial microsomia. Front Pediatr 2023; 11:1158078. [PMID: 37228439 PMCID: PMC10203510 DOI: 10.3389/fped.2023.1158078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction This study aimed to verify the accuracy and safety of distraction osteogenesis for hemifacial microsomia assisted by a robotic navigation system based on artificial intelligence. Methods The small sample early-phase single-arm clinical study, available at http://www.chictr.org.cn/index.aspx, included children aged three years and older diagnosed with unilateral hemifacial microsomia (Pruzansky-Kaban type II). A preoperative design was performed, and an intelligent robotic navigation system assisted in the intraoperative osteotomy. The primary outcome was the accuracy of distraction osteogenesis, including the positional and angular errors of the osteotomy plane and the distractor, by comparing the preoperative design plan with the actual images one week postoperatively. Perioperative indicators, pain scales, satisfaction scales, and complications at one week were also analyzed. Results Four cases (mean 6.5 years, 3 type IIa and 1 type IIb deformity) were included. According to the craniofacial images one week after surgery, the osteotomy plane positional error was 1.77 ± 0.12 mm, and the angular error was 8.94 ± 4.13°. The positional error of the distractor was 3.67 ± 0.23 mm, and the angular error was 8.13 ± 2.73°. Postoperative patient satisfaction was high, and no adverse events occurred. Discussion The robotic navigation-assisted distraction osteogenesis in hemifacial microsomia is safe, and the operational precision meets clinical requirements. Its clinical application potential is to be further explored and validated.
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Affiliation(s)
- Ziwei Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhijie Zhao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Wenqing Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Byeong Seop Kim
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingjie Yan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaojun Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Li Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Weimin Shen
- Department of Burn and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Gang Chai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Kim BS, Zhang Z, Sun M, Han W, Chen X, Yan Y, Shi Y, Xu H, Lin L, Chai G. Feasibility of a Robot-Assisted Surgical Navigation System for Mandibular Distraction Osteogenesis in Hemifacial Microsomia: A Model Experiment. J Craniofac Surg 2023; 34:525-531. [PMID: 36173942 DOI: 10.1097/scs.0000000000009028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/19/2022] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate the feasibility and accuracy of osteotomy and distractor placement using a robotic navigation system in a model surgical experiment of mandibular distraction osteogenesis for hemifacial microsomia. Imaging data from 5 patients with Pruzansky-Kaban type II (IIa: 4; IIb: 1) mandibular deformities were used to print 3D models for simulated mandibular distraction osteogenesis. In the experimental group, a robot-assisted surgical navigation system was used to perform the surgery under robotic guidance following registration, according to the preoperative design. Conventional surgery was performed in the control group, in which the operation was based on intraoperative estimations of the preoperative design by experienced surgeons. The accuracies of the osteotomy and distractor placement were assessed based on distance and angular error. Osteotomy accuracy was higher in the experimental group than in the control group, and the distance error ( t =9.311, P <0.001) and angular error ( t =5.385, P =0.001) were significantly reduced. The accuracy of distractor placement was also significantly higher in the experimental group, while the distance error ( t =3.048, P =0.016) and angular error ( t =3.524, P =0.024) were significantly reduced. The present results highlight the feasibility of robot-assisted distraction osteogenesis combined with electromagnetic navigation for improved surgical precision in clinical settings.
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Affiliation(s)
- Byeong Seop Kim
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ziwei Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengzhe Sun
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqing Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingjie Yan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunyong Shi
- Shanghai Panyan Robotics Technology Co., Shanghai, China
| | - Haisong Xu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Chai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wang Y, Cao D, Chen SL, Li YM, Zheng YW, Ohkohchi N. Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery. World J Gastrointest Surg 2021; 13:904-922. [PMID: 34621469 PMCID: PMC8462083 DOI: 10.4240/wjgs.v13.i9.904] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/19/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
With the continuous development of digital medicine, minimally invasive precision and safety have become the primary development trends in hepatobiliary surgery. Due to the specificity and complexity of hepatobiliary surgery, traditional preoperative imaging techniques such as computed tomography and magnetic resonance imaging cannot meet the need for identification of fine anatomical regions. Imaging-based three-dimensional (3D) reconstruction, virtual simulation of surgery and 3D printing optimize the surgical plan through preoperative assessment, improving the controllability and safety of intraoperative operations, and in difficult-to-reach areas of the posterior and superior liver, assistive robots reproduce the surgeon's natural movements with stable cameras, reducing natural vibrations. Electromagnetic navigation in abdominal surgery solves the problem of conventional surgery still relying on direct visual observation or preoperative image assessment. We summarize and compare these recent trends in digital medical solutions for the future development and refinement of digital medicine in hepatobiliary surgery.
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Affiliation(s)
- Yun Wang
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Di Cao
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Si-Lin Chen
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yu-Mei Li
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yun-Wen Zheng
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, and School of Biotechnology and Heath Sciences, Wuyi University, Jiangmen 529020, Guangdong Province, China
- School of Medicine, Yokohama City University, Yokohama 234-0006, Kanagawa, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
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O’Donoghue K, Jaeger HA, Cantillon-Murphy P. A Radiolucent Electromagnetic Tracking System for Use with Intraoperative X-ray Imaging. SENSORS (BASEL, SWITZERLAND) 2021; 21:3357. [PMID: 34065968 PMCID: PMC8151710 DOI: 10.3390/s21103357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 02/07/2023]
Abstract
In recent times, the use of electromagnetic tracking for navigation in surgery has quickly become a vital tool in minimally invasive surgery. In many procedures, electromagnetic tracking is used in tandem with X-ray technology to track a variety of tools and instruments. Most commercially available EM tracking systems can cause X-ray artifacts and attenuation due to their construction and the metals that form them. In this work, we provide a novel solution to this problem by creating a new radiolucent electromagnetic navigation system that has minimal impact on -ray imaging systems. This is a continuation of our previous work where we showed the development of the Anser open-source electromagnetic tracking system. Typical electromagnetic tracking systems operate by generating low frequency magnetic fields from coils that are located near the patient. These coils are typically made from copper, steel, and other dense radiopaque materials. In this work, we explore the use of low density aluminum to create these coils and we demonstrate that the effect on X-ray images is significantly reduced as a result of these novel changes in the materials used. The resulting field generator is shown to give at least a 60% reduction in the X-ray attenuation in comparison to our earlier designs. We verify that the system accuracy of approximately 1.5 mm RMS error is maintained with this change in design.
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Affiliation(s)
- Kilian O’Donoghue
- Tyndall National Institute, Dyke Parade, T12 R5CP Cork, Ireland; (H.A.J.); (P.C.-M.)
| | | | - Padraig Cantillon-Murphy
- Tyndall National Institute, Dyke Parade, T12 R5CP Cork, Ireland; (H.A.J.); (P.C.-M.)
- School of Engineering, University College Cork, T12 K8AF Cork, Ireland
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Krumb H, Das D, Chadda R, Mukhopadhyay A. CycleGAN for interpretable online EMT compensation. Int J Comput Assist Radiol Surg 2021; 16:757-765. [PMID: 33719026 PMCID: PMC8134291 DOI: 10.1007/s11548-021-02324-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/15/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Electromagnetic tracking (EMT) can partially replace X-ray guidance in minimally invasive procedures, reducing radiation in the OR. However, in this hybrid setting, EMT is disturbed by metallic distortion caused by the X-ray device. We plan to make hybrid navigation clinical reality to reduce radiation exposure for patients and surgeons, by compensating EMT error. METHODS Our online compensation strategy exploits cycle-consistent generative adversarial neural networks (CycleGAN). Positions are translated from various bedside environments to their bench equivalents, by adjusting their z-component. Domain-translated points are fine-tuned on the x-y plane to reduce error in the bench domain. We evaluate our compensation approach in a phantom experiment. RESULTS Since the domain-translation approach maps distorted points to their laboratory equivalents, predictions are consistent among different C-arm environments. Error is successfully reduced in all evaluation environments. Our qualitative phantom experiment demonstrates that our approach generalizes well to an unseen C-arm environment. CONCLUSION Adversarial, cycle-consistent training is an explicable, consistent and thus interpretable approach for online error compensation. Qualitative assessment of EMT error compensation gives a glimpse to the potential of our method for rotational error compensation.
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Affiliation(s)
- Henry Krumb
- Technische Universität Darmstadt, Darmstadt, Germany.
| | - Dhritimaan Das
- Indian Institute of Technology (IIT-BHU), Varanasi, India
| | - Romol Chadda
- Technische Universität Darmstadt, Darmstadt, Germany
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Leveraging spatial uncertainty for online error compensation in EMT. Int J Comput Assist Radiol Surg 2020; 15:1043-1051. [PMID: 32440957 PMCID: PMC7303086 DOI: 10.1007/s11548-020-02189-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 04/23/2020] [Indexed: 01/26/2023]
Abstract
Purpose Electromagnetic tracking (EMT) can potentially complement fluoroscopic navigation, reducing radiation exposure in a hybrid setting. Due to the susceptibility to external distortions, systematic error in EMT needs to be compensated algorithmically. Compensation algorithms for EMT in guidewire procedures are only practical in an online setting. Methods We collect positional data and train a symmetric artificial neural network (ANN) architecture for compensating navigation error. The results are evaluated in both online and offline scenarios and are compared to polynomial fits. We assess spatial uncertainty of the compensation proposed by the ANN. Simulations based on real data show how this uncertainty measure can be utilized to improve accuracy and limit radiation exposure in hybrid navigation. Results ANNs compensate unseen distortions by more than 70%, outperforming polynomial regression. Working on known distortions, ANNs outperform polynomials as well. We empirically demonstrate a linear relationship between tracking accuracy and model uncertainty. The effectiveness of hybrid tracking is shown in a simulation experiment. Conclusion ANNs are suitable for EMT error compensation and can generalize across unseen distortions. Model uncertainty needs to be assessed when spatial error compensation algorithms are developed, so that training data collection can be optimized. Finally, we find that error compensation in EMT reduces the need for X-ray images in hybrid navigation.
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Kügler D, Sehring J, Stefanov A, Stenin I, Kristin J, Klenzner T, Schipper J, Mukhopadhyay A. i3PosNet: instrument pose estimation from X-ray in temporal bone surgery. Int J Comput Assist Radiol Surg 2020; 15:1137-1145. [PMID: 32440956 PMCID: PMC7316684 DOI: 10.1007/s11548-020-02157-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/03/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE Accurate estimation of the position and orientation (pose) of surgical instruments is crucial for delicate minimally invasive temporal bone surgery. Current techniques lack in accuracy and/or line-of-sight constraints (conventional tracking systems) or expose the patient to prohibitive ionizing radiation (intra-operative CT). A possible solution is to capture the instrument with a c-arm at irregular intervals and recover the pose from the image. METHODS i3PosNet infers the position and orientation of instruments from images using a pose estimation network. Said framework considers localized patches and outputs pseudo-landmarks. The pose is reconstructed from pseudo-landmarks by geometric considerations. RESULTS We show i3PosNet reaches errors [Formula: see text] mm. It outperforms conventional image registration-based approaches reducing average and maximum errors by at least two thirds. i3PosNet trained on synthetic images generalizes to real X-rays without any further adaptation. CONCLUSION The translation of deep learning-based methods to surgical applications is difficult, because large representative datasets for training and testing are not available. This work empirically shows sub-millimeter pose estimation trained solely based on synthetic training data.
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Affiliation(s)
- David Kügler
- Department of Computer Science, Technischer Universität Darmstadt, Darmstadt, Germany. .,German Center for Degenerative Diseases (DZNE) e.V., Bonn, Germany.
| | - Jannik Sehring
- Department of Computer Science, Technischer Universität Darmstadt, Darmstadt, Germany
| | - Andrei Stefanov
- Department of Computer Science, Technischer Universität Darmstadt, Darmstadt, Germany
| | - Igor Stenin
- ENT Clinic, University Düsseldorf, Düsseldorf, Germany
| | - Julia Kristin
- ENT Clinic, University Düsseldorf, Düsseldorf, Germany
| | | | - Jörg Schipper
- ENT Clinic, University Düsseldorf, Düsseldorf, Germany
| | - Anirban Mukhopadhyay
- Department of Computer Science, Technischer Universität Darmstadt, Darmstadt, Germany
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