Evaluation of a system for high-accuracy 3D image-based registration of endoscopic video to c-arm cone-beam CT for image-guided skull base surgery

Daniel J. Mirota, Ali Uneri, Sebastian Schafer, Sajendra Nithiananthan, Douglas D. Reh, Masaru Ishii, Gary L. Gallia, Russell H. Taylor, Gregory D. Hager, Jeffrey H. Siewerdsen

Research output: Contribution to journalArticle

Abstract

The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) or, more recently, intraoperative cone-beam CT (CBCT). The ability to register real-time endoscopic video with CBCT offers an additional advantage by rendering information directly within the visual scene to account for intraoperative anatomical change. However, tracker localization error ( ∼1√hbox{ - }2 mm ) limits the accuracy with which video and tomographic images can be registered. This paper reports the first implementation of image-based video-CBCT registration, conducts a detailed quantitation of the dependence of registration accuracy on system parameters, and demonstrates improvement in registration accuracy achieved by the image-based approach. Performance was evaluated as a function of parameters intrinsic to the image-based approach, including system geometry, CBCT image quality, and computational runtime. Overall system performance was evaluated in a cadaver study simulating transsphenoidal skull base tumor excision. Results demonstrated significant improvement (p < 0.001) in registration accuracy with a mean reprojection distance error of 1.28 mm for the image-based approach versus 1.82 mm for the conventional tracker-based method. Image-based registration was highly robust against CBCT image quality factors of noise and resolution, permitting integration with low-dose intraoperative CBCT.

Original languageEnglish (US)
Article number6422396
Pages (from-to)1215-1226
Number of pages12
JournalIEEE transactions on medical imaging
Volume32
Issue number7
DOIs
StatePublished - Jan 1 2013

Keywords

  • Cone-beam computed tomography (CBCT)
  • endoscopy
  • image-guided treatment
  • registration
  • surgical guidance/navigation

ASJC Scopus subject areas

  • Software
  • Radiological and Ultrasound Technology
  • Computer Science Applications
  • Electrical and Electronic Engineering

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