Cardin M A, Wang J X, Lobaugh N J, Guimont I, Plewes D B
Imaging Research Department, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Comput Aided Surg. 2007 Mar;12(2):71-81. doi: 10.3109/10929080701253634.
Computer assisted surgery (CAS) for tumor resection can assist the surgeon in locating the tumor margin accurately via some form of guidance method. A wide array of guidance methods can be considered, including model-based visual representations, symbolic graphical interfaces, and those based on other sensory cues such as sound. Given the variety of these guidance methods, it becomes increasingly important to test and analyze guidance methods for CAS in a quantitative and context-dependent manner to determine which is most suitable for a given surgical task. In this paper, we present a novel experimental methodology and analysis framework to test candidate guidance methods for CAS. Different viewpoints and stereographic, symbolic and auditory cues were tested in isolation or in combination in a set of virtual surgery experiments. A total of 28 participants were asked to circumscribe a virtual tumor with a magnetically tracked scalpel while measuring the surgical trajectory. This allowed measurement of surgical accuracy, speed, and the frequency with which the tumor margin was intersected, and enabled a quantitative comparison of guidance approaches. This study demonstrated that adding sound to pictorial guidance methods consistently improved accuracy, speed and margin intersection of the virtual surgery. However, the use of stereovision showed less benefit than expected. While guidance based on a combination of symbolic and pictorial cues enhanced accuracy, we found that speed could be substantially impaired. These studies demonstrate that optimal guidance combinations exist which would not be apparent by studying individual guidance methods in isolation. Our findings suggest that care is needed when using expensive and sometimes cumbersome virtual visualization technologies for CAS, and that simpler, non-stereo presentation may be sufficient for specific surgical tasks.
用于肿瘤切除的计算机辅助手术（CAS）可通过某种形式的引导方法帮助外科医生准确确定肿瘤边界。可以考虑多种引导方法，包括基于模型的视觉表示、符号图形界面以及基于声音等其他感官线索的方法。鉴于这些引导方法的多样性，以定量且依赖于上下文的方式测试和分析CAS的引导方法，以确定哪种方法最适合特定的手术任务变得越来越重要。在本文中，我们提出了一种新颖的实验方法和分析框架，用于测试CAS的候选引导方法。在一组虚拟手术实验中，分别或组合测试了不同的视角以及立体、符号和听觉线索。共有28名参与者被要求使用磁跟踪手术刀围绕虚拟肿瘤进行环切，同时测量手术轨迹。这使得能够测量手术的准确性、速度以及与肿瘤边界相交的频率，并能够对引导方法进行定量比较。这项研究表明，在图像引导方法中添加声音能够持续提高虚拟手术的准确性、速度和边界相交率。然而，立体视觉的使用所带来的益处比预期的要少。虽然基于符号和图像线索组合的引导提高了准确性，但我们发现速度可能会大幅下降。这些研究表明，存在最佳的引导组合，而单独研究个体引导方法时这些组合并不明显。我们的研究结果表明，在将昂贵且有时繁琐的虚拟可视化技术用于CAS时需要谨慎，对于特定的手术任务，更简单的非立体呈现可能就足够了。
