Is a Depth Camera in Agreement with an Electromagnetic Tracking Device when Measuring Head Position?

Introduction

Clinicians typically observe and describe abnormal head postures (AHPs) and may also measure them. Depth cameras have been suggested as a reliable measurement device for measuring head position using face-tracking technology. This study compared a depth camera (Microsoft Kinect) to a gold standard electromagnetic tracking system (Polhemus device) to measure head position.

Method

Twenty healthy volunteers (mean age 21 years) had their head position simultaneously recorded using the depth camera (Kinect) and the electromagnetic tracking system (Polhemus). Participants were asked to make 30-degree head movements into chin up, chin down, head turn and head tilt positions. The head movement made and the stability of the head at each position were recorded and analysed.

Results

Compared to the electromagnetic tracking system (Polhemus), the depth camera (Kinect) always measured a smaller head movement. Measurements with the two devices were not statistically significantly different for turn right (P = 0.3955, p > 0.05), turn left (P = 0.4749, p > 0.05), tilt right (P = 0.7086, p > 0.05) and tilt left (P = 0.4091, p > 0.05) head movements. However, the smaller depth camera measurement of chin up and chin down head movements were statistically significant, chin up (P = 0.0001, p < 0.01) and chin down (P = 0.0005, p < 0.001). At each eccentric position, the depth camera (Kinect) recordings were more variable than the electromagnetic tracking system (Polhemus).

Conclusions

Compared to the electromagnetic tracking system (Polhemus), the depth camera (Kinect) was comparable for measuring head turns and tilts but was less accurate at measuring chin up and chin down head positions. Further research is needed before the depth cameras are considered for clinical recordings of head position.

Quantifying wrist angular excursion on impact for Jab and Hook lead arm shots in boxing

The hand region is reported as the most common injury site in boxing, with more observed time loss than any other area in this sport. The amount of wrist motion, specifically flexion, has been described as contributing to these injuries, yet no literature is available to quantify wrist kinematics in boxing. This is the first paper describing wrist motion on impact in boxing. Utilising an electromagnetic tracking system, two types of shots were assessed, Jab (straight arm) and Hook (bent arm), during in-vivo testing procedures with 29 elite boxers. For both shots, flexion and ulnar deviation occurred concurrent on impact, with an M and SD of 9.3 ± 1.9° and 4.7 ± 1.2° respectively for Jab shots, and 5.5 ± 1.1° and 3.3 ± 1.1° respectively for Hook shots, supporting dart throwing motion at the wrist. For both Jab & Hook, wrist motion on impact occurred within >30% and >20% respectively of total available active range of motion, with wrist angles greater in both flexion (t = 9.0, p < 0.001, d = 1.7) and ulnar deviation (t = 8.4, p < 0.001, d = 1.6) for Jab compared to Hook shots. The study provides novel and quantifiable information regarding wrist kinematics during the impact phase of punching and potentially an improved understanding of injury mechanisms in boxing.

Instrument localisation for endovascular aneurysm repair: Comparison of two methods based on tracking systems or using imaging

BACKGROUND

In endovascular aneuysm repair (EVAR) procedures, medical instruments are currently navigated with a two-dimensional imaging based guidance requiring X-rays and contrast agent.

METHODS

Novel approaches for obtaining the three-dimensional instrument positions are introduced. Firstly, a method based on fibre optical shape sensing, one electromagnetic sensor and a preoperative computed tomography (CT) scan is described. Secondly, an approach based on image processing using one 2D fluoroscopic image and a preoperative CT scan is introduced.

RESULTS

For the tracking based method, average errors from 1.81 to 3.13 mm and maximum errors from 3.21 to 5.46 mm were measured. For the image-based approach, average errors from 3.07 to 6.02 mm and maximum errors from 8.05 to 15.75 mm were measured.

CONCLUSION

The tracking based method is promising for usage in EVAR procedures. For the image-based approach are applications in smaller vessels more suitable, since its errors increase with the vessel diameter.

Assessment of Position Repeatability Error in an Electromagnetic Tracking System for Surgical Navigation.Sensors (Basel). 2020;20. [PMID: 32053941 DOI: 10.3390/s20040961]

In this paper we present a study of the repeatability of an innovative electromagnetic tracking system (EMTS) for surgical navigation, developed to overcome the state of the art of current commercial systems, allowing for the placement of the magnetic field generator far from the operating table. Previous studies led to the development of a preliminary EMTS prototype. Several hardware improvements are described, which result in noise reduction in both signal generation and the measurement process, as shown by experimental tests. The analysis of experimental results has highlighted the presence of drift in voltage components, whose effect has been quantified and related to the variation of the sensor position. Repeatability in the sensor position measurement is evaluated by means of the propagation of the voltage repeatability error, and the results are compared with the performance of the Aurora system (which represents the state of the art for EMTS for surgical navigation), showing a repeatability error about ten times lower. Finally, the proposed improvements aim to overcome the limited operating distance between the field generator and electromagnetic (EM) sensors provided by commercial EM tracking systems for surgical applications and seem to provide a not negligible technological advantage.

Technical Note: Assessment of electromagnetic tracking systems in a surgical environment using ultrasonography and ureteroscopy instruments for percutaneous renal access

PURPOSE

Electromagnetic tracking systems (EMTSs) have been proposed to assist the percutaneous renal access (PRA) during minimally invasive interventions to the renal system. However, the influence of other surgical instruments widely used during PRA (like ureteroscopy and ultrasound equipment) in the EMTS performance is not completely known. This work performs this assessment for two EMTSs [Aurora^® Planar Field Generator (PFG); Aurora^® Tabletop Field Generator (TTFG)].

METHODS

An assessment platform, composed by a scaffold with specific supports to attach the surgical instruments and a plate phantom with multiple levels to precisely translate or rotate the surgical instruments, was developed. The median accuracy and precision in terms of position and orientation were estimated for the PFG and TTFG in a surgical environment using this platform. Then, the influence of different surgical instruments (alone or together), namely analogic flexible ureterorenoscope (AUR), digital flexible ureterorenoscope (DUR), two-dimensional (2D) ultrasound (US) probe, and four-dimensional (4D) mechanical US probe, was assessed for both EMTSs by coupling the instruments to 5-DOF and 6-DOF sensors.

RESULTS

Overall, the median positional and orientation accuracies in the surgical environment were 0.85 mm and 0.42° for PFG, and 0.72 mm and 0.39° for TTFG, while precisions were 0.10 mm and 0.03° for PFG, and 0.20 mm and 0.12° for TTFG, respectively. No significant differences were found for accuracy between EMTSs. However, PFG showed a tendency for higher precision than TTFG. AUR, DUR, and 2D US probe did not influence the accuracy and precision of both EMTSs. In opposition, the 4D probe distorted the signal near the attached sensor, making readings unreliable.

CONCLUSIONS

Ureteroscopy- and ultrasonography-assisted PRA based on EMTS guidance are feasible with the tested AUR or DUR together with the 2D probe. More studies must be performed to evaluate the probes and ureterorenoscopes' influence before their use in PRA based on EMTS guidance.

Test-retest reliability of segment kinetic energy measures in the golf swing

Analyses of segment kinetic energy (KE) can provide the most appropriate means of exploring sequential movements. As the reliability associated with its measurement has not been reported, the aim of this study was to examine the test-retest reliability of segment KE measures in the golf swing. On two occasions, seven male golfers hit five shots with three different clubs. Body segment inertia parameters were estimated for 17 rigid bodies and 3D kinematic data were collected during each swing. The magnitude and timing of peak total, linear and angular kinetic energies were then calculated for each rigid body and for four segment groups. Regardless of club type, KE was measured with high reliability for almost all rigid bodies and segment groups. However, significantly larger magnitudes of peak total (p = 0.039) and linear (p = 0.021) lower body KE were reported in test 2 than in test 1. The high reliability reported in this study provides support for the use of analyses of segment kinetic energy. However, practitioners should pay careful attention to the identification of anatomical landmarks which define the thigh, pelvis and thorax as this was the main cause of variability in repeated measures of segment kinetic energy.

[Design of Electromagnetic Tracking System Using Rotating Magnetic Field Based on DSP]

This paper realized an electromagnetic tracking system based on electrically-controlled rotating magnetic field. A tracking system using the digital signal processor (DSP) as the control processing device was developed, including a controllable constant current source module, a magnetic field source module, a three-axis magnetic sensor and ADC interface circuit. The experimental results verified that each time the system could be stable positioning, average error of position was 0.282 cm, the average error of orientation was 0.696o, the positioning time was 1.572 s. Through calibration and further improvement of the hardware circuit, the performance of the system is expected to further improve.

A preliminary study on surgical navigation for epiduroscopic laser neural decompression

Epiduroscopic laser neural decompression is an emerging therapeutic modality to treat lumbar spine pathologies including chronic low back pain, spinal stenosis, and disk herniation via catheter insertion followed by laser ablation of the lesion. Despite the efficacy of epiduroscopic laser neural decompression, excessive radiation doses due to fluoroscopy during epiduroscopic laser neural decompression have limited its widespread application. To address the issue, we propose a surgical navigation system to assist in epiduroscopic laser neural decompression procedures using radiation-free image guidance. An electromagnetic tracking system was used as the basic modality to track the internal location of the surgical instrument with respect to the patient body. Patient-to-image registration was carried out using the point-based registration method to determine the transformation between the coordinate system of the patient and that of the medical images. We applied the proposed system in epiduroscopic laser neural decompression procedures to assess its effectiveness, and the outcomes confirmed its clinical feasibility. To the best of our knowledge, this is a report on the first surgical navigation applied for epiduroscopic laser neural decompression procedure.