High-performance intraoperative Cone-beam CT on a mobile C-Arm: An integrated system for guidance of head and neck surgery

J. H. Siewerdsen, M. J. Daly, H. Chan, S. Nithiananthan, N. Hamming, K. K. Brock, J. C. Irishe

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

Abstract

A system for intraoperative cone-beam CT (CBCT) surgical guidance is under development and translation to trials in head and neck surgery. The system provides 3D image updates on demand with sub-millimeter spatial resolution and soft-tissue visibility at low radiation dose, thus overcoming conventional limitations associated with preoperative imaging alone. A prototype mobile C-arm provides the imaging platform, which has been integrated with several novel subsystems for streamlined implementation in the OR,including: real-time tracking of surgical instruments and endoscopy (with automatic registration of image and world reference frames); fast 3D deformable image registration (a newly developed multi-scale Demons algorithm); 3D planning and definition of target and normal structures; and registration / visualization of intraoperative CBCT with the surgical plan, preoperative images, and endoscopic video. Quantitative evaluation of surgical performance demonstrates a significant advantage in achieving complete tumor excision in challenging sinus and skull base ablation tasks. The ability to visualize the surgical plan in the context of intraoperative image data delineating residual tumor and neighboring critical structures presents a significant advantage to surgical performance and evaluation of the surgical product. The system has been translated to a prospective trial involving 12 patients undergoing head and neck surgery - the first implementation of the research prototype in the clinical setting. The trial demonstrates the value of high-performance intraoperative 3D imaging and provides a valuable basis for human factors analysis and workflow studies that will greatly augment streamlined implementation of such systems in complex OR environments.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2009
Subtitle of host publicationVisualization, Image-Guided Procedures, and Modeling
DOIs
StatePublished - Jun 19 2009
Externally publishedYes
EventMedical Imaging 2009: Biomedical Applications in Molecular, Structural, and Functional Imaging - Lake Buena Vista, FL, United States
Duration: Feb 8 2009Feb 10 2009

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume7261
ISSN (Print)1605-7422

Other

OtherMedical Imaging 2009: Biomedical Applications in Molecular, Structural, and Functional Imaging
CountryUnited States
CityLake Buena Vista, FL
Period2/8/092/10/09

Keywords

  • 3D imaging
  • C-arm
  • Cone-beam CT
  • Flat-panel detector
  • Head and neck surgery
  • Image registration
  • Image-guided interventions
  • Surgicalnavigation

ASJC Scopus subject areas

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

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  • Cite this

    Siewerdsen, J. H., Daly, M. J., Chan, H., Nithiananthan, S., Hamming, N., Brock, K. K., & Irishe, J. C. (2009). High-performance intraoperative Cone-beam CT on a mobile C-Arm: An integrated system for guidance of head and neck surgery. In Medical Imaging 2009: Visualization, Image-Guided Procedures, and Modeling [72610J] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 7261). https://doi.org/10.1117/12.813747