Johns Hopkins researchers have devised a computerized process that could make minimally invasive surgery more accurate and streamlined using equipment already common in the operating room.
In a report published recently in the journal Physics in Medicine and Biology,the researchers say initial testing of the algorithm shows that their image-based guidance system is potentially superior to conventional tracking systems that have been the mainstay of surgical navigation over the last decade.
“Imaging in the operating room opens new possibilities for patient safety and high-precision surgical guidance,” says Jeffrey Siewerdsen, Ph.D., a professor of biomedical engineering in the Johns Hopkins University School of Medicine. “In this work, we devised an imaging method that could overcome traditional barriers in precision and workflow. Rather than adding complicated tracking systems and special markers to the already busy surgical scene, we realized a method in which the imaging system is the tracker and the patient is the marker.”
Siewerdsen explains that current state-of-the-art surgical navigation involves an often cumbersome process in which someone — usually a surgical technician, resident or fellow — manually matches points on the patient’s body to those in a preoperative CT image. This process, called registration, enables a computer to orient the image of the patient within the geometry of the operating room. “The registration process can be error-prone, require multiple manual attempts to achieve high accuracy and tends to degrade over the course of the operation,” Siewerdsen says.
Siewerdsen’s team used a mobile C-arm, already a piece of equipment used in many surgeries, to develop an alternative. They suspected that a fast, accurate registration algorithm could be devised to match two-dimensional X-ray images to the three-dimensional preoperative CT scan in a way that would be automatic and remain up to date throughout the operation.
Starting with a mathematical algorithm they had previously developed to help surgeonslocate specific vertebrae during spine surgery, the team adapted the method to the task of surgical navigation. When they tested the method on cadavers, they found a level of accuracy better than 2 millimeters and consistently better than a conventional surgical tracker, which has 2 to 4 millimeters of accuracy in surgical settings.
“The breakthrough came when we discovered how much geometric information could be extracted from just one or two X-ray images of the patient,” says Ali Uneri, a graduate student in the Department of Computer Science in the Johns Hopkins University Whiting School of Engineering. “From just a single frame, we achieved better than 3 millimeters of accuracy, and with two frames acquired with a small angular separation, we could provide surgical navigation more accurately than a conventional tracker.”
The team investigated how small the angle between the two images could be without compromising accuracy and found that as little as 15 degrees was sufficient to provide better than 2 millimeters of accuracy.
An additional advantage of the system, Uneri says, is that the two X-ray images can be acquired at extremely low dose of radiation — far below what is needed for a visually clear image, but enough for the algorithm to extract accurate geometric information.
The team is translating the method to a system suitable for clinical studies. While the system could potentially be used in a wide range of procedures, Siewerdsen expects it to be most useful in minimally invasive surgeries, such as spinal and intracranial neurosurgery.
A. Jay Khanna, M.D., an associate professor of orthopaedic surgery and biomedical engineering at the Johns Hopkins University School of Medicine, evaluated the system in its first application to spine surgery. “Accurate surgical navigation is essential to high-quality minimally invasive surgery,” he says. “But conventional navigation systems can present a major cost barrier and a bottleneck to workflow. This system could provide accurate navigation with simple systems that are already in the OR and with a sophisticated registration algorithm under the hood.”
The Latest on: Surgical navigation
via Google News
The Latest on: Surgical navigation
- Breast cancer survivors share how treatment options have improvedon October 14, 2019 at 2:56 pm
Honestly, I thought they had the wrong patient,” Dr. Vinyard says. Her own fight lead her to specialize in breast surgical oncology. Dr. Vinyard went from breast cancer patient to breast cancer ...
- Surgical Robots Market 2019 Industry Developments, Outlook, Current Trends by 2024 - MRE Analysison October 14, 2019 at 12:40 pm
Surgical robots are presently utilized as a part of different sorts of surgeries ... By Equipment Type Analysis this market is segmented on the basis of Robot Machines, Navigation Systems, Planners ...
- Xoran lands $8M grant for CT scanner, aims to research navigation and imaging in spineon October 14, 2019 at 9:42 am
4. Xoran plans to research surgical navigation and intraoperative imaging to decrease time and enhance outcomes in minimally invasive spine procedures.
- Surgical Robots Market by Top key Players are Stryker, Smith & Nephew, Zimmer Biometon October 14, 2019 at 6:31 am
The system allows surgical navigation and positioning for operations related to neurological body parts, wherein extreme precision methods are required. Fortune Business Insights predicts that ...
- Brainlab Rolls Out Mobile Intraoperative Imaging Robot, Literally!on October 11, 2019 at 9:09 am
According to Brainlab, “The Loop-X imaging robot integrates with Brainlab Elements software as well as Kick and Curve Navigation and functions with Cirq and Quentry, maximizing interoperability and ...
- Xoran Receives Multi-Million Dollar SBIR Grant Funding from the NIH with additional matching funds from external investors, Decathlon Capital Partnerson October 10, 2019 at 9:51 am
ANN ARBOR, Mich., Oct. 10, 2019 /PRNewswire/ -- Xoran Technologies, LLC has been awarded an $8M matching grant by the National Institutes of Health (NIH) to integrate and commercialize Xoran's mobile ...
- Surgical Navigation Systems Market – Global Industry Analysis, Size, Share, Trends, Growth and Forecast 2019 – 2024on October 9, 2019 at 7:30 am
The worldwide Surgical Navigation Systems market has been concentrated to give an exact and canny examination into the ongoing business inclines, the aggressive scene and incorporates local ...
- Global Surgical Navigation Systems Market Analysis, Trends, and Forecasts 2019-2025on October 8, 2019 at 5:13 pm
Dublin, Oct. 08, 2019 (GLOBE NEWSWIRE) -- The "Surgical Navigation Systems - Market Analysis, Trends, and Forecasts" report has been added to ResearchAndMarkets.com's offering. Surgical Navigation ...
- Former surgical tech at Springfield hospital gets prison time for lying on job applicationon October 8, 2019 at 3:42 pm
In 1988, Pluchino was issued a social security number and illegally obtained two additional ones in 1991 and 2000. In November 2013, Pluchino used one of the social security numbers to apply for a job ...
- “Surgical Theater” gives 3D view of your brainon October 4, 2019 at 2:45 am
Norton Children’s is the first pediatric hospital in the region to offer Surgical Theater, virtual reality technology that creates an immersive 3D view of a patient’s skull and brain. Using VR goggles ...
via Bing News