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将增强现实成像与内镜视图融合用于经鼻颅底手术;一种基于术中锥形束计算机断层扫描和光学跟踪的新型手术导航应用。

Fusion of augmented reality imaging with the endoscopic view for endonasal skull base surgery; a novel application for surgical navigation based on intraoperative cone beam computed tomography and optical tracking.

机构信息

Philips Research, Eindhoven, The Netherlands.

Eindhoven University of Technology (TU/e), Eindhoven, The Netherlands.

出版信息

PLoS One. 2020 Jan 16;15(1):e0227312. doi: 10.1371/journal.pone.0227312. eCollection 2020.


DOI:10.1371/journal.pone.0227312
PMID:31945082
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6964902/
Abstract

OBJECTIVE: Surgical navigation is a well-established tool in endoscopic skull base surgery. However, navigational and endoscopic views are usually displayed on separate monitors, forcing the surgeon to focus on one or the other. Aiming to provide real-time integration of endoscopic and diagnostic imaging information, we present a new navigation technique based on augmented reality with fusion of intraoperative cone beam computed tomography (CBCT) on the endoscopic view. The aim of this study was to evaluate the accuracy of the method. MATERIAL AND METHODS: An augmented reality surgical navigation system (ARSN) with 3D CBCT capability was used. The navigation system incorporates an optical tracking system (OTS) with four video cameras embedded in the flat detector of the motorized C-arm. Intra-operative CBCT images were fused with the view of the surgical field obtained by the endoscope's camera. Accuracy of CBCT image co-registration was tested using a custom-made grid with incorporated 3D spheres. RESULTS: Co-registration of the CBCT image on the endoscopic view was performed. Accuracy of the overlay, measured as mean target registration error (TRE), was 0.55 mm with a standard deviation of 0.24 mm and with a median value of 0.51mm and interquartile range of 0.39--0.68 mm. CONCLUSION: We present a novel augmented reality surgical navigation system, with fusion of intraoperative CBCT on the endoscopic view. The system shows sub-millimeter accuracy.

摘要

目的:手术导航是内镜颅底手术中一种成熟的工具。然而,导航视图和内镜视图通常显示在单独的监视器上,这迫使外科医生专注于其中一个视图。为了提供内镜和诊断成像信息的实时集成,我们提出了一种新的基于增强现实的导航技术,该技术融合了术中锥形束计算机断层扫描(CBCT)在内镜视图上的应用。本研究旨在评估该方法的准确性。

材料和方法:使用具有 3D CBCT 功能的增强现实手术导航系统(ARSN)。导航系统集成了光学跟踪系统(OTS),该系统将四个摄像机嵌入在电动 C 臂的平板探测器中。术中 CBCT 图像与内窥镜相机获得的手术视野视图融合。使用带有内置 3D 球体的定制网格测试 CBCT 图像配准的准确性。

结果:成功实现了 CBCT 图像在内镜视图上的配准。叠加的准确性,以平均目标配准误差(TRE)衡量,为 0.55 毫米,标准偏差为 0.24 毫米,中位数为 0.51 毫米,四分位间距为 0.39--0.68 毫米。

结论:我们提出了一种新的增强现实手术导航系统,该系统将术中 CBCT 融合到内镜视图中。该系统具有亚毫米级的准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/234513dbd0a5/pone.0227312.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/fddfc02e35c4/pone.0227312.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/f8817e74cdc7/pone.0227312.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/3b2a628806f5/pone.0227312.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/53eb975c2ac2/pone.0227312.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/810b1cfa3857/pone.0227312.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/ad6696d3349e/pone.0227312.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/2c501664a377/pone.0227312.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/07871ff1c92a/pone.0227312.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/234513dbd0a5/pone.0227312.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/fddfc02e35c4/pone.0227312.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/f8817e74cdc7/pone.0227312.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/3b2a628806f5/pone.0227312.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/53eb975c2ac2/pone.0227312.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/810b1cfa3857/pone.0227312.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/ad6696d3349e/pone.0227312.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/2c501664a377/pone.0227312.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/07871ff1c92a/pone.0227312.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d1d/6964902/234513dbd0a5/pone.0227312.g009.jpg

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本文引用的文献

[1]
A Novel Augmented-Reality-Based Surgical Navigation System for Spine Surgery in a Hybrid Operating Room: Design, Workflow, and Clinical Applications.

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World J Plast Surg. 2019-5

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