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Lu W, Chen J, Wang Y, Chang W, Wang Y, Chen C, Dong L, Liang P, Kong D. Coplanarity Constrained Ultrasound Probe Calibration Based on N-Wire Phantom. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2316-2324. [PMID: 37541788 DOI: 10.1016/j.ultrasmedbio.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE N-wire phantom-based ultrasound probe calibration has been used widely in many freehand tracked ultrasound imaging systems. The calibration matrix is obtained by registering the coplanar point cloud in ultrasound space and non-coplanar point cloud in tracking sensor space based on the least squares method. This method is sensitive to outliers and loses the coplanar information of the fiducial points. In this article, we describe a coplanarity-constrained calibration algorithm focusing on these issues. METHODS We verified that the out-of-plane error along the oblique wire in the N-wire phantom followed a normal distribution and used it to remove the experimental outliers and fit the plane with the Levenberg-Marquardt algorithm. Then, we projected the points to the plane along the oblique wire. Coplanarity-constrained point cloud registration was used to calculate the transformation matrix. RESULTS Compared with the other two commonly used methods, our method had the best calibration precision and achieved 25% and 36% improvement of the mean calibration accuracy than the closed-form solution and in-plane error method respectively at depth 16. Experiments at different depths revealed that our algorithm had better performance in our setup. CONCLUSION Our proposed coplanarity-constrained calibration algorithm achieved significant improvement in both precision and accuracy compared with existing algorithms with the same N-wire phantom. It is expected that calibration accuracy will improve when the algorithm is applied to all other N-wire phantom-based calibration procedures.
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Affiliation(s)
- Wenliang Lu
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Jiye Chen
- Fifth Medical Center, Chinese PLA General Hospital, Beijing, China; Chinese PLA Medical School, Beijing, China
| | - Yuan Wang
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Wanru Chang
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Yun Wang
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | | | - Linan Dong
- Department of Interventional Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Fifth Medical Center, Chinese PLA General Hospital, Beijing, China; Chinese PLA Medical School, Beijing, China
| | - Dexing Kong
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China.
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2
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Bekedam NM, Karssemakers LHE, van Alphen MJA, van Veen RLP, Smeele LE, Karakullukcu MB. Comparison of image quality of 3D ultrasound: motorized acquisition versus freehand navigated acquisition, a phantom study. Int J Comput Assist Radiol Surg 2023; 18:1649-1663. [PMID: 37243918 PMCID: PMC10491552 DOI: 10.1007/s11548-023-02934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/21/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE Intra-operative assessment of resection margins during oncological surgery is a field that needs improvement. Ultrasound (US) shows the potential to fulfill this need, but this imaging technique is highly operator-dependent. A 3D US image of the whole specimen may remedy the operator dependence. This study aims to compare and evaluate the image quality of 3D US between freehand acquisition (FA) and motorized acquisition (MA). METHODS Multiple 3D US volumes of a commercial phantom were acquired in motorized and freehand fashion. FA images were collected with electromagnetic navigation. An integrated algorithm reconstructed the FA images. MA images were stacked into a 3D volume. The image quality is evaluated following the metrics: contrast resolution, axial and elevation resolution, axial and elevation distance calibration, stability, inter-operator variability, and intra-operator variability. A linear mixed model determined statistical differences between FA and MA for these metrics. RESULTS The MA results in a statistically significant lower error of axial distance calibration (p < 0.0001) and higher stability (p < 0.0001) than FA. On the other hand, the FA has a better elevation resolution (p < 0.003) than the MA. CONCLUSION MA results in better image quality of 3D US than the FA method based on axial distance calibration, stability, and variability. This study suggests acquiring 3D US volumes for intra-operative ex vivo margin assessment in a motorized fashion.
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Affiliation(s)
- N M Bekedam
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Academic Centre of Dentistry Amsterdam, Vrije Universiteit, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - L H E Karssemakers
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - M J A van Alphen
- Department of Head and Neck Surgery and Oncology, Verwelius 3D Lab, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - R L P van Veen
- Department of Head and Neck Surgery and Oncology, Verwelius 3D Lab, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - L E Smeele
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - M B Karakullukcu
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
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Wang Y, Fu T, Wu C, Fan J, Song H, Xiao D, Lin Y, Liu F, Yang J. Adaptive tetrahedral interpolation for reconstruction of uneven freehand 3D ultrasound. Phys Med Biol 2023; 68. [PMID: 36731138 DOI: 10.1088/1361-6560/acb88c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 02/02/2023] [Indexed: 02/04/2023]
Abstract
Objective.Freehand 3D ultrasound volume reconstruction has received considerable attention in medical research because it can freely perform spatial imaging at a low cost. However, the uneven distribution of the original ultrasound images in space reduces the reconstruction effect of the traditional method.Approach.An adaptive tetrahedral interpolation algorithm is proposed to reconstruct 3D ultrasound volume data. The algorithm adaptively divides the unevenly distributed images into numerous tetrahedrons and interpolates the voxel value in each tetrahedron to reconstruct 3D ultrasound volume data.Main results.Extensive experiments on simulated and clinical data confirm that the proposed method can achieve more accurate reconstruction than six benchmark methods. Specifically, the averaged interpolation error at the gray level can be reduced by 0.22-0.82, and the peak signal-to-noise ratio and the mean structure similarity can be improved by 0.32-1.83 dB and 0.01-0.05, respectively.Significance.With the parallel implementation of the algorithm, one 3D ultrasound volume data with size 279 × 279 × 276 can be reconstructed from 100 slices 2D ultrasound images with size 200 × 200 at 1.04 s. Such a quick and accurate approach has practical value in medical research.
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Affiliation(s)
- Yifan Wang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Tianyu Fu
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Chan Wu
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Jingfan Fan
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Hong Song
- School of Software, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Deqiang Xiao
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Yucong Lin
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, People's Republic of China
| | - Fangyi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, People's Republic of China
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4
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Wu C, Fu T, Chen X, Xiao J, Ai D, Fan J, Lin Y, Song H, Yang J. Automatic spatial calibration of freehand ultrasound probe with a multilayer N-wire phantom. ULTRASONICS 2023; 128:106862. [PMID: 36240539 DOI: 10.1016/j.ultras.2022.106862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/25/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
The classic N-wire phantom has been widely used in the calibration of freehand ultrasound probes. One of the main challenges of the phantom is accurately identifying N-fiducials in ultrasound images, especially with multiple N-wire structures. In this study, a method using a multilayer N-wire phantom for the automatic spatial calibration of ultrasound images is proposed. All dots in the ultrasound image are segmented, scored, and classified according to the unique geometric features of the multilayer N-wire phantom. A recognition method for identifying N-fiducials from the dots is proposed for calibrating the spatial transformation of the ultrasound probe. At depths of 9, 11, 13, and 15 cm, the reconstruction error of 50 points is 1.24 ± 0.16, 1.09 ± 0.06, 0.95 ± 0.08, 1.02 ± 0.05 mm, respectively. The reconstruction mockup test shows that the distance accuracy is 1.11 ± 0.82 mm at a depth of 15 cm.
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Affiliation(s)
- Chan Wu
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
| | - Tianyu Fu
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China.
| | - Xinyu Chen
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
| | - Jian Xiao
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
| | - Danni Ai
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
| | - Jingfan Fan
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
| | - Yucong Lin
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China.
| | - Hong Song
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing 100081, China
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Kildahl-Andersen A, Hofstad EF, Peters K, Van Beek G, Sorger H, Amundsen T, Langø T, Leira HO. A novel clip-on device for electromagnetic tracking in endobronchial ultrasound bronchoscopy. MINIM INVASIV THER 2022; 31:1041-1049. [DOI: 10.1080/13645706.2022.2091937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Arne Kildahl-Andersen
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | | | | | - Hanne Sorger
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
| | - Tore Amundsen
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Thomas Langø
- Department of Health Research, SINTEF Digital, Trondheim, Norway
- Department of Research, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Håkon Olav Leira
- St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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6
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Ultrasound-based navigation for open liver surgery using active liver tracking. Int J Comput Assist Radiol Surg 2022; 17:1765-1773. [PMID: 35622201 DOI: 10.1007/s11548-022-02659-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/25/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Despite extensive preoperative imaging, intraoperative localization of liver lesions after systemic treatment can be challenging. Therefore, an image-guided navigation setup is explored that links preoperative diagnostic scans and 3D models to intraoperative ultrasound (US), enabling overlay of detailed diagnostic images on intraoperative US. Aim of this study is to assess the workflow and accuracy of such a navigation system which compensates for liver motion. METHODS Electromagnetic (EM) tracking was used for organ tracking and movement of the transducer. After laparotomy, a sensor was attached to the liver surface while the EM-tracked US transducer enabled image acquisition and landmark digitization. Landmarks surrounding the lesion were selected during patient-specific preoperative 3D planning and identified for registration during surgery. Endpoints were accuracy and additional times of the investigative steps. Accuracy was computed at the center of the target lesion. RESULTS In total, 22 navigated procedures were performed. Navigation provided useful visualization of preoperative 3D models and their overlay on US imaging. Landmark-based registration resulted in a mean fiducial registration error of 10.3 ± 4.3 mm, and a mean target registration error of 8.5 ± 4.2 mm. Navigation was available after an average of 12.7 min. CONCLUSION We developed a navigation method combining ultrasound with active liver tracking for organ motion compensation, with an accuracy below 10 mm. Fixation of the liver sensor near the target lesion compensates for local movement and contributes to improved reliability during navigation. This represents an important step forward in providing surgical navigation throughout the procedure. TRIAL REGISTRATION This study is registered in the Netherlands Trial Register (number NL7951).
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7
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Ipsen S, Wulff D, Kuhlemann I, Schweikard A, Ernst F. Towards automated ultrasound imaging-robotic image acquisition in liver and prostate for long-term motion monitoring. Phys Med Biol 2021; 66. [PMID: 33770768 DOI: 10.1088/1361-6560/abf277] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/26/2021] [Indexed: 11/12/2022]
Abstract
Real-time volumetric (4D) ultrasound has shown high potential for diagnostic and therapy guidance tasks. One of the main drawbacks of ultrasound imaging to date is the reliance on manual probe positioning and the resulting user dependence. Robotic assistance could help overcome this issue and facilitate the acquisition of long-term image data to observe dynamic processesin vivoover time. The aim of this study is to assess the feasibility of robotic probe manipulation and organ motion quantification during extended imaging sessions. The system consists of a collaborative robot and a 4D ultrasound system providing real-time data access. Five healthy volunteers received liver and prostate scans during free breathing over 30 min. Initial probe placement was performed with real-time remote control with a predefined contact force of 10 N. During scan acquisition, the probe position was continuously adjusted to the body surface motion using impedance control. Ultrasound volumes, the pose of the end-effector and the estimated contact forces were recorded. For motion analysis, one anatomical landmark was manually annotated in a subset of ultrasound frames for each experiment. Probe contact was uninterrupted over the entire scan duration in all ten sessions. Organ drift and imaging artefacts were successfully compensated using remote control. The median contact force along the probe's longitudinal axis was 10.0 N with maximum values of 13.2 and 21.3 N for liver and prostate, respectively. Forces exceeding 11 N only occurred in 0.3% of the time. Probe and landmark motion were more pronounced in the liver, with median interquartile ranges of 1.5 and 9.6 mm, compared to 0.6 and 2.7 mm in the prostate. The results show that robotic ultrasound imaging with dynamic force control can be used for stable, long-term imaging of anatomical regions affected by motion. The system facilitates the acquisition of 4D image datain vivoover extended scanning periods for the first time and holds the potential to be used for motion monitoring for therapy guidance as well as diagnostic tasks.
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Affiliation(s)
- Svenja Ipsen
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany.,Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering IMTE, Luebeck, Germany
| | - Daniel Wulff
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - Ivo Kuhlemann
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - Achim Schweikard
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - Floris Ernst
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
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8
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Pérez de Frutos J, Hofstad EF, Solberg OV, Tangen GA, Lindseth F, Langø T, Elle OJ, Mårvik R. Laboratory test of Single Landmark registration method for ultrasound-based navigation in laparoscopy using an open-source platform. Int J Comput Assist Radiol Surg 2018; 13:1927-1936. [PMID: 30074134 PMCID: PMC6223760 DOI: 10.1007/s11548-018-1830-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/26/2018] [Indexed: 02/04/2023]
Abstract
Purpose Test the feasibility of the novel Single Landmark image-to-patient registration method for use in the operating room for future clinical trials. The algorithm is implemented in the open-source platform CustusX, a computer-aided intervention research platform dedicated to intraoperative navigation and ultrasound, with an interface for laparoscopic ultrasound probes.
Methods The Single Landmark method is compared to fiducial landmark on an IOUSFAN (Kyoto Kagaku Co., Ltd., Japan) soft tissue abdominal phantom and T2 magnetic resonance scans of it. Results The experiments show that the accuracy of the Single Landmark registration is good close to the registered point, increasing with the distance from this point (12.4 mm error at 60 mm away from the registered point). In this point, the registration accuracy is mainly dominated by the accuracy of the user when clicking on the ultrasound image. In the presented set-up, the time required to perform the Single Landmark registration is 40% less than for the FLRM. Conclusion The Single Landmark registration is suitable for being integrated in a laparoscopic workflow. The statistical analysis shows robustness against translational displacements of the patient and improvements in terms of time. The proposed method allows the clinician to accurately register lesions intraoperatively by clicking on these in the ultrasound image provided by the ultrasound transducer. The Single Landmark registration method can be further combined with other more accurate registration approaches improving the registration at relevant points defined by the clinicians.
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Affiliation(s)
| | | | | | | | - Frank Lindseth
- Department of Health, SINTEF A.S., Trondheim, Norway.,Computer Science Department, NTNU, Trondheim, Norway
| | - Thomas Langø
- Department of Health, SINTEF A.S., Trondheim, Norway
| | | | - Ronald Mårvik
- Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim, Norway
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Tümer N, Kok AC, Vos FM, Streekstra GJ, Askeland C, Tuijthof GJM, Zadpoor AA. Three-Dimensional Registration of Freehand-Tracked Ultrasound to CT Images of the Talocrural Joint. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2375. [PMID: 30037099 PMCID: PMC6068753 DOI: 10.3390/s18072375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/09/2018] [Accepted: 07/19/2018] [Indexed: 12/11/2022]
Abstract
A rigid surface⁻volume registration scheme is presented in this study to register computed tomography (CT) and free-hand tracked ultrasound (US) images of the talocrural joint. Prior to registration, bone surfaces expected to be visible in US are extracted from the CT volume and bone contours in 2D US data are enhanced based on monogenic signal representation of 2D US images. A 3D monogenic signal data is reconstructed from the 2D data using the position of the US probe recorded with an optical tracking system. When registering the surface extracted from the CT scan to the monogenic signal feature volume, six transformation parameters are estimated so as to optimize the sum of monogenic signal features over the transformed surface. The robustness of the registration algorithm was tested on a dataset collected from 12 cadaveric ankles. The proposed method was used in a clinical case study to investigate the potential of US imaging for pre-operative planning of arthroscopic access to talar (osteo)chondral defects (OCDs). The results suggest that registrations with a registration error of 2 mm and less is achievable, and US has the potential to be used in assessment of an OCD' arthroscopic accessibility, given the fact that 51% of the talar surface could be visualized.
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Affiliation(s)
- Nazlı Tümer
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft, The Netherlands.
| | - Aimee C Kok
- Orthopaedic Research Center Amsterdam, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Frans M Vos
- Department of Imaging Science and Technology, Quantitative Imaging Group, Delft University of Technology (TU Delft), Lorentzweg 1, 2628 CJ Delft, The Netherlands.
- Department of Radiology, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Geert J Streekstra
- Department of Radiology, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | | | - Gabrielle J M Tuijthof
- Orthopaedic Research Center Amsterdam, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Zuyd University of Applied Sciences, Research Centre Smart Devices, Nieuw Eyckholt 300, 6419 DJ Heerlen, The Netherlands.
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft, The Netherlands.
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Rethy A, Sæternes JO, Halgunset J, Mårvik R, Hofstad EF, Sánchez-Margallo JA, Langø T. Anthropomorphic liver phantom with flow for multimodal image-guided liver therapy research and training. Int J Comput Assist Radiol Surg 2017; 13:61-72. [PMID: 28929364 PMCID: PMC5754383 DOI: 10.1007/s11548-017-1669-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/11/2017] [Indexed: 11/11/2022]
Abstract
Purpose The objective of this study was to develop a multimodal, permanent liver phantom displaying functional vasculature and common pathologies, for teaching, training and equipment development in laparoscopic ultrasound and navigation. Methods Molten wax was injected simultaneously into the portal and hepatic veins of a human liver. Upon solidification of the wax, the surrounding liver tissue was dissolved, leaving a cast of the vessels. A connection was established between the two vascular trees by manually manipulating the wax. The cast was placed, along with different multimodal tumor models, in a liver shaped mold, which was subsequently filled with a polymer. After curing, the wax was melted and flushed out of the model, thereby establishing a system of interconnected channels, replicating the major vasculature of the original liver. Thus, a liquid can be circulated through the model in a way that closely mimics the natural blood flow. Results Both the tumor models, i.e., the metastatic tumors, hepatocellular carcinoma and benign cyst, and the vessels inside the liver model, were clearly visualized by all the three imaging modalities: CT, MR and ultrasound. Doppler ultrasound images of the vessels proved the blood flow functionality of the phantom. Conclusion By a two-step casting procedure, we produced a multimodal liver phantom, with open vascular channels, and tumor models, that is the next best thing to practicing imaging and guidance procedures in animals or humans. The technique is in principle applicable to any organ of the body.
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Affiliation(s)
- Anna Rethy
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jørn Ove Sæternes
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Jostein Halgunset
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Ronald Mårvik
- Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Erlend F Hofstad
- Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Medical Technology, SINTEF, 7465, Trondheim, Norway
| | - Juan A Sánchez-Margallo
- Department of Medical Technology, SINTEF, 7465, Trondheim, Norway.,Department of Computer Systems and Telematics Engineering, University of Extremadura, Badajoz, Spain
| | - Thomas Langø
- Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. .,Department of Medical Technology, SINTEF, 7465, Trondheim, Norway.
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11
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Sorger H, Hofstad EF, Amundsen T, Langø T, Bakeng JBL, Leira HO. A multimodal image guiding system for Navigated Ultrasound Bronchoscopy (EBUS): A human feasibility study. PLoS One 2017; 12:e0171841. [PMID: 28182758 PMCID: PMC5300184 DOI: 10.1371/journal.pone.0171841] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/26/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is the endoscopic method of choice for confirming lung cancer metastasis to mediastinal lymph nodes. Precision is crucial for correct staging and clinical decision-making. Navigation and multimodal imaging can potentially improve EBUS-TBNA efficiency. AIMS To demonstrate the feasibility of a multimodal image guiding system using electromagnetic navigation for ultrasound bronchoschopy in humans. METHODS Four patients referred for lung cancer diagnosis and staging with EBUS-TBNA were enrolled in the study. Target lymph nodes were predefined from the preoperative computed tomography (CT) images. A prototype convex probe ultrasound bronchoscope with an attached sensor for position tracking was used for EBUS-TBNA. Electromagnetic tracking of the ultrasound bronchoscope and ultrasound images allowed fusion of preoperative CT and intraoperative ultrasound in the navigation software. Navigated EBUS-TBNA was used to guide target lymph node localization and sampling. Navigation system accuracy was calculated, measured by the deviation between lymph node position in ultrasound and CT in three planes. Procedure time, diagnostic yield and adverse events were recorded. RESULTS Preoperative CT and real-time ultrasound images were successfully fused and displayed in the navigation software during the procedures. Overall navigation accuracy (11 measurements) was 10.0 ± 3.8 mm, maximum 17.6 mm, minimum 4.5 mm. An adequate sample was obtained in 6/6 (100%) of targeted lymph nodes. No adverse events were registered. CONCLUSIONS Electromagnetic navigated EBUS-TBNA was feasible, safe and easy in this human pilot study. The clinical usefulness was clearly demonstrated. Fusion of real-time ultrasound, preoperative CT and electromagnetic navigational bronchoscopy provided a controlled guiding to level of target, intraoperative overview and procedure documentation.
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Affiliation(s)
- Hanne Sorger
- Department of Circulation and Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Thoracic Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Medicine, Levanger Hospital, North-Trøndelag Health Trust, Norway
| | - Erlend Fagertun Hofstad
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- Norwegian National Advisory Unit for Ultrasound and image-guided therapy, St. Olavs Hospital, Trondheim, Norway
| | - Tore Amundsen
- Department of Circulation and Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Thoracic Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Thomas Langø
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- Norwegian National Advisory Unit for Ultrasound and image-guided therapy, St. Olavs Hospital, Trondheim, Norway
| | - Janne Beate Lervik Bakeng
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
- Norwegian National Advisory Unit for Ultrasound and image-guided therapy, St. Olavs Hospital, Trondheim, Norway
| | - Håkon Olav Leira
- Department of Circulation and Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Thoracic Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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12
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Sorger H, Hofstad EF, Amundsen T, Langø T, Leira HO. A novel platform for electromagnetic navigated ultrasound bronchoscopy (EBUS). Int J Comput Assist Radiol Surg 2015; 11:1431-43. [PMID: 26615428 PMCID: PMC4958402 DOI: 10.1007/s11548-015-1326-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/06/2015] [Indexed: 12/25/2022]
Abstract
Purpose Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes is essential for lung cancer staging and distinction between curative and palliative treatment. Precise sampling is crucial. Navigation and multimodal imaging may improve the efficiency of EBUS-TBNA. We demonstrate a novel EBUS-TBNA navigation system in a dedicated airway phantom. Methods Using a convex probe EBUS bronchoscope (CP-EBUS) with an integrated sensor for electromagnetic (EM) position tracking, we performed navigated CP-EBUS in a phantom. Preoperative computed tomography (CT) and real-time ultrasound (US) images were integrated into a navigation platform for EM navigated bronchoscopy. The coordinates of targets in CT and US volumes were registered in the navigation system, and the position deviation was calculated. Results The system visualized all tumor models and displayed their fused CT and US images in correct positions in the navigation system. Navigating the EBUS bronchoscope was fast and easy. Mean error observed between US and CT positions for 11 target lesions (37 measurements) was \documentclass[12pt]{minimal}
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\begin{document}$$2.8\pm 1.0$$\end{document}2.8±1.0 mm, maximum error was 5.9 mm. Conclusion The feasibility of our novel navigated CP-EBUS system was successfully demonstrated. An EBUS navigation system is needed to meet future requirements of precise mediastinal lymph node mapping, and provides new opportunities for procedure documentation in EBUS-TBNA.
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Affiliation(s)
- Hanne Sorger
- Department of Thoracic Medicine, St. Olavs Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway. .,Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), AHL-senteret, Prinsesse Kristinas gate 3, Trondheim, Norway. .,Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway.
| | | | - Tore Amundsen
- Department of Thoracic Medicine, St. Olavs Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), AHL-senteret, Prinsesse Kristinas gate 3, Trondheim, Norway
| | - Thomas Langø
- Department Medical Technology, SINTEF, Technology and Society, Trondheim, Norway
| | - Håkon Olav Leira
- Department of Thoracic Medicine, St. Olavs Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), AHL-senteret, Prinsesse Kristinas gate 3, Trondheim, Norway
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13
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Askeland C, Solberg OV, Bakeng JBL, Reinertsen I, Tangen GA, Hofstad EF, Iversen DH, Våpenstad C, Selbekk T, Langø T, Hernes TAN, Olav Leira H, Unsgård G, Lindseth F. CustusX: an open-source research platform for image-guided therapy. Int J Comput Assist Radiol Surg 2015; 11:505-19. [PMID: 26410841 PMCID: PMC4819973 DOI: 10.1007/s11548-015-1292-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 08/31/2015] [Indexed: 12/14/2022]
Abstract
Purpose CustusX is an image-guided therapy (IGT) research platform dedicated to intraoperative navigation and ultrasound imaging. In this paper, we present CustusX as a robust, accurate, and extensible platform with full access to data and algorithms and show examples of application in technological and clinical IGT research. Methods CustusX has been developed continuously for more than 15 years based on requirements from clinical and technological researchers within the framework of a well-defined software quality process. The platform was designed as a layered architecture with plugins based on the CTK/OSGi framework, a superbuild that manages dependencies and features supporting the IGT workflow. We describe the use of the system in several different clinical settings and characterize major aspects of the system such as accuracy, frame rate, and latency. Results The validation experiments show a navigation system accuracy of \documentclass[12pt]{minimal}
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\begin{document}$$<$$\end{document}<1.1 mm, a frame rate of 20 fps, and latency of 285 ms for a typical setup. The current platform is extensible, user-friendly and has a streamlined architecture and quality process. CustusX has successfully been used for IGT research in neurosurgery, laparoscopic surgery, vascular surgery, and bronchoscopy. Conclusions CustusX is now a mature research platform for intraoperative navigation and ultrasound imaging and is ready for use by the IGT research community. CustusX is open-source and freely available at http://www.custusx.org.
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Affiliation(s)
- Christian Askeland
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway. .,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway.
| | - Ole Vegard Solberg
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
| | | | - Ingerid Reinertsen
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
| | - Geir Arne Tangen
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway
| | | | - Daniel Høyer Iversen
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway.,Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Cecilie Våpenstad
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway.,Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tormod Selbekk
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Thomas Langø
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Toril A Nagelhus Hernes
- Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Håkon Olav Leira
- Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Geirmund Unsgård
- Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Frank Lindseth
- Department of Medical Technology, SINTEF Technology and Society, Trondheim, Norway.,Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
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