scholarly journals Psychoakustische Sonifikation zur Navigation in bildgeführter Chirurgie

2020 ◽  
Author(s):  
Tim Ziemer ◽  
Holger Schultheis
Keyword(s):  
High Resolution ◽  
Cognitive Load ◽  
Operating Room ◽  
Image Guidance ◽  
Visual Channel ◽  
Research Project ◽  
Image Guided ◽  
Linear Dimensions

Sonification is the systematic transformation of data to sound. Sonification is a means to communicate information, to support navigation, or to explore data. In a multi-disciplinary research project we develop a psychoacoustically-motivated sonification that supports surgeons’ orientation in image-guided interventions. One drawback of image-guidance is that neither the location of monitors nor the displayed view on the patient’s anatomy coincides with the actual viewpoint of the surgeon. Surgeons need to mentally scale, rotate, and translate the displayed graphics. These operations are cognitively demanding. Sonification can reduce cognitive load and relieve the visual channel to improve the ergonomic situation in the operating room by communicating the location of the target, relative to the tool tip, like the center of a tumor relative to the ablation needle. By means of psychoacoustic sonification we ensure that the sounds are readily interpretable in terms of orthogonal and linear dimensions with a high resolution.

Operating room radiation exposure in cone beam computed tomography–based, image-guided spinal surgery

2013 ◽  
Vol 19 (2) ◽  
pp. 226-231 ◽  
Author(s):  
Eric W. Nottmeier ◽  
Stephen M. Pirris ◽  
Steven Edwards ◽  
Sherri Kimes ◽  
Cammi Bowman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Operating Room ◽  
Cone Beam Computed Tomography ◽  
Spinal Surgery ◽  
Image Guidance ◽  
Cone Beam ◽  
3D Image ◽  
Image Guided ◽  
Radiation Scatter

Object Surgeon and operating room (OR) staff radiation exposure during spinal surgery is a concern, especially with the increasing use of multiplanar fluoroscopy in minimally invasive spinal surgery procedures. Cone beam computed tomography (cbCT)–based, 3D image guidance does not involve the use of active fluoroscopy during instrumentation placement and therefore decreases radiation exposure for the surgeon and OR staff during spinal fusion procedures. However, the radiation scatter of a cbCT device can be similar to that of a standard 64-slice CT scanner and thus could expose the surgeon and OR staff to radiation during image acquisition. The purpose of the present study was to measure radiation exposure at several unshielded locations in the OR when using cbCT in conjunction with 3D image-guided spinal surgery in 25 spinal surgery cases. Methods Five unshielded badge dosimeters were placed at set locations in the OR during 25 spinal surgery cases in which cbCT-based, 3D image guidance was used. The cbCT device (O-ARM) was used in conjunction with the Stealth S7 image-guided platform. The radiology department analyzed the badge dosimeters after completion of the last case. Results Fifty high-definition O-ARM spins were performed in 25 patients for spinal registration and to check instrumentation placement. Image-guided placement of 124 screws from C-2 to the ileum was accomplished without complication. Badge dosimetry analysis revealed minimal radiation exposure for the badges 6 feet from the gantry in the area of the anesthesiology equipment, as well as for the badges located 10–13 feet from the gantry on each side of the room (mean 0.7–3.6 mrem/spin). The greatest radiation exposure occurred on the badge attached to the OR table within the gantry (mean 176.9 mrem/spin), as well as on the control panel adjacent to the gantry (mean 128.0 mrem/spin). Conclusions Radiation scatter from the O-ARM was minimal at various distances outside of and not adjacent to the gantry. Although the average radiation exposure at these locations was low, an earlier study, undertaken in a similar fashion, revealed no radiation exposure when the surgeon stood behind a lead shield. This simple precaution can eliminate the small amount of radiation exposure to OR staff in cases in which the O-ARM is used.

397 Intra-tumor immunotherapy injections utilizing image guidance in interventional radiology: clinical trial experience at a tertiary care cancer center

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A422-A422
Author(s):  
Ravi Murthy ◽  
Rahul Sheth ◽  
Alda Tam ◽  
Sanjay Gupta ◽  
Vivek Subbiah ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Interventional Radiology ◽  
Real Time ◽  
Image Guidance ◽  
Tertiary Care ◽  
Cancer Center ◽  
Imaging Guidance ◽  
Image Guided ◽  
Real Time Image ◽  
Time Image

BackgroundImage guided intra-tumor administration of investigational immunotherapeutic agents represents an expanding field of interest. We present a retrospective review of the safety, feasibility & technical nuances of real-time image guidance for injection & biopsy across a spectrum of extracranial solid malignancies utilizing the discipline of Interventional Radiology.MethodsPatients who were enrolled in image guided intratumoral immunotherapy injection (ITITI) clinical trials over a 6 year period (2013–19) at a single tertiary care cancer center were included in this analysis. Malignancy, location, imaging guidance utilized for ITITI & biopsy for injected (adscopal) & non-injected (abscopal) lesions were determined and categorized. Peri-procedural adverse events were noted.Results262 pts (146 female, 61 yrs median) participating in 29 immunotherapeutic clinical trials (TLR & STING agonists, gene therapy, anti CD-40, viral/bacterial/metabolic oncolytics) met study criteria. Malignancies included melanoma 88, sarcoma 32, colorectal 29, breast 23, lung 17, head & neck 15, ovarian 8, neuroendocrine 7, pancreatic adenocarcinoma 6, 3 each (cholangioCA, endometrial, bladder, GI tract), 2 each (RCC, thymicCA, lymphoma, merkel cell, prostate) & others 1 each (CUP, GIST, dermatofibrosarcoma, DSRT, neuroblastoma, thyroid). All 169 & 93 patients received the intended 1371 ITITI in parietal (abdominal/chest wall, extremity, neck, pelvis) or visceral (liver, lung, peritoneum, adrenal) locations respectively; 83 patients received lymph node injections within either location. Imaging guidance was US in 68% of the cohort (US 161, CT+US 19); CT was used in 30% (81) & MRI in 1 patient. Median diameter of the ITITI lesion was 32 mm (8–230 mm). Median volume of the ITITI therapeutic material/session was 2 ml (1–6.9 ml). Lesions were accessed using a coaxial technique. ITITI delivery needles used at operator preference & tailored to lesion characteristics were either a 21G/22G Chiba, 21G Profusion (Cook Medical), 22G Morrison (AprioMed), 25G hypodermic (BD) & 18G Quadrafuse (Rex Medical). 2840 core biopsies (>18G Tru-cut core, Mission, Bard Medical) were performed in 237 patients during 690 procedures; biopsy sessions were often concurrent & of the ITITI site. 137 patients also underwent biopsy of a non-ITITI site (89 parietal location). Dimensions of the non-ITITI lesion were median 10 mm (7–113 mm); US image guidance was used in 97 patients (72%) to obtain a total of 1257, >18G Tru-core samples. 1.3% of injections resulted in SAE (NCI CTC AE >3) and 0.5% of 4097 biopsies developed major complications (SIR Criteria); both categories were manageable.ConclusionsUtilizing real time image guidance, ITITI to the administration of a myriad of investigational immunotherapeutic agents with concomitant biopsy procedures to date are associated with a high technical success rate & favorable safety profile.AcknowledgementsJoshua Hein, Mara Castaneda, Jyotsna Pera, Yunfang Jiang,Shuang Liu, Holly Liu and Anna LuiTrial RegistrationN/AEthics ApprovalThe study was approved by Institution’s Ethics Board, approval number 2020-0536: A retrospective study to determine the safety, feasibility and technical challenges of real-time image guidance for intra-tumor injection and biopsy across multiple solid tumors.Consent2020-0536 Waiver of Informed ConsentReferenceSheth RA, Murthy R, Hong DS, et al. Assessment of image-guided intratumoral delivery of immunotherapeutics in patients with cancer. JAMA Netw Open 2020;3(7):e207911. doi:10.1001/jamanetworkopen.2020.7911

Future Directions in Robotic Neurosurgery

2021 ◽  
Author(s):  
Christopher R Wagner ◽  
Timothy Phillips ◽  
Serge Roux ◽  
Joseph P Corrigan
Keyword(s):  
Machine Learning ◽  
Operating Room ◽  
Key Factors ◽  
Future Directions ◽  
Factors Affecting ◽  
Implementation Challenges ◽  
Image Guided ◽  
Robotic Neurosurgery ◽  
Specific Technology ◽  
Technology Trends

Abstract In this paper, we highlight promising technologies in each phase of a robotic neurosurgery operation, and identify key factors affecting how quickly these technologies will mature into products in the operating room. We focus on specific technology trends in image-guided cranial and spinal procedures, including advances in imaging, machine learning, robotics, and novel interfaces. For each technology, we discuss the required effort to overcome safety or implementation challenges, as well as identifying example regulatory approved products in related fields for comparison. The goal is to provide a roadmap for clinicians as to which robotic and automation technologies are in the developmental pipeline, and which ones are likely to impact their practice sooner, rather than later.

Integrating Image-Guidance into the Cardiac Operating Room

2000 ◽  
Vol 9 (6) ◽  
pp. 403-409 ◽  
Author(s):  
E. Fosse ◽  
P. K. Hol ◽  
E. Samset ◽  
O. J. Elle ◽  
J. S. RõStnes ◽  
...  
Keyword(s):  
Operating Room ◽  
Image Guidance

Optimal Fiducial Configuration in Image-Guided Neurosurgery Using a Genetic Algorithm

2010 ◽  
Vol 4 (4) ◽  
Author(s):  
Laura Gastaldi ◽  
Alessandro Battezzato ◽  
Claudio Bernucci ◽  
Marco Mannino ◽  
Stefano Pastorelli
Keyword(s):  
Genetic Algorithm ◽  
Image Guidance ◽  
3D Model ◽  
Magnetic Resonance Images ◽  
Optimal Placement ◽  
Fiducial Markers ◽  
Virtual Spaces ◽  
Target Registration Error ◽  
Image Guided ◽  
Localize Lesion

Image-guided neurosurgery allows surgeons to navigate and localize lesion through the patient’s cranium with a 3D image guidance. The model of the head is reconstructed using preoperative computed tomography or magnetic resonance images and real and virtual spaces are aligned by means of fiducial markers placed on the patient. In this paper, a new method for the optimal placement of the fiducial markers in order to reduce misalignment is presented. Using routine diagnostic images, a customized 3D model of the patient’s cranium is reconstructed. A genetic algorithm calculates optimal positions of the marker in order to minimize the target registration error. The fiducial set is shown to the surgeons on the 3D model to help him/her in placement of them.

TH-C-210A-04: New High Resolution Dynamic Detectors and Flow Modifying Stents for Neuro-Endovascular Image Guided Interventions

2009 ◽  
Vol 36 (6Part27) ◽  
pp. 2805-2806
Author(s):  
S Rudin ◽  
CN Ionita ◽  
A Kuhls-Gilcrist ◽  
A Jain ◽  
C Keleshis ◽  
...  
Keyword(s):  
High Resolution ◽  
Image Guided

scholarly journals Real-time image-guided electromagnetic navigation bronchoscopy dual-marker technique to localize deep pulmonary nodules in a hybrid operating room

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i103-i105
Author(s):  
Chuan Cheng ◽  
Hsin-Yueh Fang ◽  
Chih-Tsung Wen ◽  
Yin-Kai Chao
Keyword(s):  
Operating Room ◽  
Near Infrared ◽  
Pulmonary Nodules ◽  
Surface Marker ◽  
Hybrid Operating Room ◽  
Electromagnetic Navigation ◽  
Image Guided ◽  
Real Time Image ◽  
Near Infrared Dye ◽  
Time Image

Abstract Herein, we describe a Dyna-computed tomography-guided electromagnetic navigation bronchoscopy technique aimed at localizing deep pulmonary nodules. The method was implemented in a hybrid operating room and required the use of 2 markers (a near-infrared dye as a surface marker and a microcoil as a deep marker).

High-resolution three-dimensional T2-weighted sequence for neuronavigation: a new setup and clinical trial

2005 ◽  
Vol 102 (4) ◽  
pp. 658-663 ◽  
Author(s):  
Jan Gralla ◽  
Raphael Guzman ◽  
Caspar Brekenfeld ◽  
Luca Remonda ◽  
Claus Kiefer
Keyword(s):  
Clinical Trial ◽  
High Resolution ◽  
Clinical Application ◽  
Three Dimensional ◽  
Whole Body ◽  
Low Grade ◽  
Data Set ◽  
Content Type ◽  
Image Guided ◽  
Fine Print

Object. Conventional imaging for neuronavigation is performed using high-resolution computerized tomography (CT) scanning or a T1-weighted isovoxel magnetic resonance (MR) sequence. The extension of some lesions, however, is depicted much better on T2-weighted MR images. A possible fusion process used to match low-resolution T2-weighted MR image set with a referenced CT or T1-weighted data set leads to poor resolution in the three-dimensional (3D) reconstruction and decreases accuracy, which is unacceptable for neuronavigation. The object of this work was to develop a 3D T2-weighted isovoxel sequence (3D turbo—spin echo [TSE]) for image-guided neuronavigation of the whole brain and to evaluate its clinical application. Methods. The authors performed a phantom study and a clinical trial on a newly developed T2-weighted isovoxel sequence, 3D TSE, for image-guided neuronavigation using a common 1.5-tesla MR imager (Siemens Sonata whole-body imager). The accuracy study and intraoperative image guidance were performed with the aid of the pointer-based Medtronic Stealth Station Treon. The 3D TSE data set was easily applied to the navigational setup and demonstrated a high registration accuracy during the experimental trial and during an initial prospective clinical trial in 25 patients. The sequence displayed common disposable skin fiducial markers and provided convincing delineation of lesions that appear hyperintense on T2-weighted images such as low-grade gliomas and cavernomas in its clinical application. Conclusions. Three-dimensional TSE imaging broadens the spectrum of navigational and intraoperative data sets, especially for lesions that appear hyperintense on T2-weighted images. The accuracy of its registration is very reliable and it enables high-resolution reconstruction in any orientation, maintaining the advantages of image-guided surgery.

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