Yamashita Makoto, Matsumoto Nozomu, Cho Byunghyun, Komune Noritaka, Onogi Shinya, Lee Jongseung, Bano Jordan, Akahoshi Tomohiko, Hashizume Makoto
Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
Int J Comput Assist Radiol Surg. 2016 Nov;11(11):2119-2127. doi: 10.1007/s11548-016-1441-0. Epub 2016 Jun 14.
Image-guided surgery (IGS) for otological procedures requires minimal invasiveness and a high degree of accuracy. We have recently developed a noninvasive registration method, the Surface Template-Assisted Marker Positioning (STAMP) method, which uses a rigid template of the surface of the temporal bone. However, the STAMP method is not applicable when the bony surface is not exposed, such as in endoscopic surgery. Thus, we extended our research to apply the STAMP method onto the skin and tested its feasibility in this study.
We designed a phantom made of a rigid box and soft material for the study. The target registration error (TRE) was measured at preset measuring points in the phantom. We modified the STAMP method to be applicable for use on the skin around the ears (S-STAMP). The same phantom was also registered using the conventional, manually scanned surface matching method. We compared the TRE after the different registration methods.
The TRE after the S-STAMP registration method was significantly smaller than that of the conventional surface matching method at all error measurement points in the phantom. However, the TRE after the S-STAMP registration method was significantly larger than that of paired point registration using invasive fiducial markers.
The S-STAMP method using a rigid template on the soft surface yields a significantly smaller TRE than that of conventional, manually scanned surface matching registration. This strategy provides an alternative option to improve the accuracy of IGS without loading patients with additional invasive procedures.
耳科手术的图像引导手术（IGS）需要微创性和高度准确性。我们最近开发了一种非侵入性配准方法，即表面模板辅助标记定位（STAMP）方法，该方法使用颞骨表面的刚性模板。然而，当骨表面未暴露时，如在内镜手术中，STAMP方法并不适用。因此，我们扩展了研究，将STAMP方法应用于皮肤，并在本研究中测试其可行性。
我们设计了一个由刚性盒子和软材料制成的模型用于该研究。在模型中的预设测量点测量目标配准误差（TRE）。我们对STAMP方法进行了修改，使其适用于耳部周围皮肤（S-STAMP）。同样的模型也使用传统的手动扫描表面匹配方法进行配准。我们比较了不同配准方法后的TRE。
在模型的所有误差测量点，S-STAMP配准方法后的TRE明显小于传统表面匹配方法。然而，S-STAMP配准方法后的TRE明显大于使用侵入性基准标记的配对点配准。
在软表面使用刚性模板的S-STAMP方法产生的TRE明显小于传统的手动扫描表面匹配配准。该策略提供了一种替代选择，可在不给患者增加额外侵入性操作的情况下提高IGS的准确性。
