A clinical pilot study of a modular video-CT augmentation system for image-guided skull base surgery

Wen P. Liu, Daniel J. Mirota, Ali Uneri, Yoshito Otake, Gregory Hager, Douglas D. Reh, Masaru Ishii, Gary L. Gallia, Jeffrey H. Siewerdsen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Augmentation of endoscopic video with preoperative or intraoperative image data [e.g., planning data and/or anatomical segmentations defined in computed tomography (CT) and magnetic resonance (MR)], can improve navigation, spatial orientation, confidence, and tissue resection in skull base surgery, especially with respect to critical neurovascular structures that may be difficult to visualize in the video scene. This paper presents the engineering and evaluation of a video augmentation system for endoscopic skull base surgery translated to use in a clinical study. Extension of previous research yielded a practical system with a modular design that can be applied to other endoscopic surgeries, including orthopedic, abdominal, and thoracic procedures. A clinical pilot study is underway to assess feasibility and benefit to surgical performance by overlaying CT or MR planning data in realtime, high-definition endoscopic video. Preoperative planning included segmentation of the carotid arteries, optic nerves, and surgical target volume (e.g., tumor). An automated camera calibration process was developed that demonstrates mean re-projection accuracy (0.7±0.3) pixels and mean target registration error of (2.3±1.5) mm. An IRB-approved clinical study involving fifteen patients undergoing skull base tumor surgery is underway in which each surgery includes the experimental video-CT system deployed in parallel to the standard-of-care (unaugmented) video display. Questionnaires distributed to one neurosurgeon and two otolaryngologists are used to assess primary outcome measures regarding the benefit to surgical confidence in localizing critical structures and targets by means of video overlay during surgical approach, resection, and reconstruction.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2012
Subtitle of host publicationImage-Guided Procedures, Robotic Interventions, and Modeling
DOIs
StatePublished - May 1 2012
EventMedical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling - San Diego, CA, United States
Duration: Feb 5 2012Feb 7 2012

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume8316
ISSN (Print)1605-7422

Other

OtherMedical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling
CountryUnited States
CitySan Diego, CA
Period2/5/122/7/12

Keywords

  • image-guided surgery
  • skull-base surgery
  • surgical navigation
  • video endoscopy
  • video-CT augmentation

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Liu, W. P., Mirota, D. J., Uneri, A., Otake, Y., Hager, G., Reh, D. D., Ishii, M., Gallia, G. L., & Siewerdsen, J. H. (2012). A clinical pilot study of a modular video-CT augmentation system for image-guided skull base surgery. In Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling [831633] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 8316). https://doi.org/10.1117/12.911724