@inproceedings{3a095f38a4a444489042c8de9eadc25f,
title = "A 3d-elastography-guided system for laparoscopic partial nephrectomies",
abstract = "We present an image-guided intervention system based on tracked 3D elasticity imaging (EI) to provide a novel interventional modality for registration with pre-operative CT. The system can be integrated in both laparoscopic and robotic partial nephrectomies scenarios, where this new use of EI makes exact intra-operative execution of pre-operative planning possible. Quick acquisition and registration of 3D-B-Mode and 3D-EI volume data allows intra-operative registration with CT and thus with pre-defined target and critical regions (e.g. tumors and vasculature). Their real-time location information is then overlaid onto a tracked endoscopic video stream to help the surgeon avoid vessel damage and still completely resect tumors including safety boundaries. The presented system promises to increase the success rate for partial nephrectomies and potentially for a wide range of other laparoscopic and robotic soft tissue interventions. This is enabled by the three components of robust real-time elastography, fast 3D-EI/CT registration, and intra-operative tracking. With high quality, robust strain imaging (through a combination of parallelized 2D-EI, optimal frame pair selection, and optimized palpation motions), kidney tumors that were previously unregistrable or sometimes even considered isoechoic with conventional B-mode ultrasound can now be imaged reliably in interventional settings. Furthermore, this allows the transformation of planning CT data of kidney ROIs to the intra-operative setting with a markerless mutual-information-based registration, using EM sensors for intraoperative motion tracking. Overall, we present a complete procedure and its development, including new phantom models - both ex vivo and synthetic - to validate image-guided technology and training, tracked elasticity imaging, real-time EI frame selection, registration of CT with EI, and finally a real-time, distributed software architecture. Together, the system allows the surgeon to concentrate on intervention completion with less time pressure.",
keywords = "Distributed software, Elastography, Navigation, Partial nephrectomy, Registration, Ultrasound",
author = "Stolka, {Philipp J.} and Matthias Keil and Georgios Sakas and Eliott McVeigh and Allaf, {Mohamad E.} and Taylor, {Russell H.} and Boctor, {Emad M.}",
note = "Funding Information: Further support was provided by internal funds of the Johns Hopkins University and by the Fraunhofer Gesellschaft within the PROFIL program. Equipment support was generously provided by Ultrasonix (Sonix RP/CEP ultrasound), Siemens Medical Systems (Antares ultrasound), Dymax Europe (Medi Cure biocompatible glue), and the ERC-CISST (robotic stage). We also gratefully acknowledge the research efforts and extensive development contributions of our students, in particular of Hyun-Jae Kang and Nishikant Deshmukh. Publisher Copyright: {\textcopyright} 2010 SPIE.; Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling ; Conference date: 14-02-2010 Through 16-02-2010",
year = "2010",
doi = "10.1117/12.844589",
language = "English (US)",
series = "Progress in Biomedical Optics and Imaging - Proceedings of SPIE",
publisher = "SPIE",
editor = "Wong, {Kenneth H.} and Miga, {Michael I.}",
booktitle = "Medical Imaging 2010",
}