Abstract
A new image-guided microscope system using augmented reality image overlays has been developed. With this system, CT cut-views and segmented objects such as tumors that have been previously extracted from preoperative tomographic images can be directly displayed as augmented reality overlays on the microscope image. The novelty of this design stems from the inclusion of a precise mini-tracker directly on the microscope. This device, which is rigidly mounted to the microscope, is used to track the movements of surgical tools and the patient. In addition to an accuracy gain, this setup offers improved ergonomics since it is much easier for the surgeon to keep an unobstructed line of sight to tracked objects. We describe the components of the system: microscope calibration, image registration, tracker assembly and registration, tool tracking, and augmented reality display. The accuracy of the system has been measured by validation on plastic skulls and cadaver heads, obtaining an overlay error of 0.7 mm. In addition, a numerical simulation of the system has been done in order to complement the accuracy study, showing that the integration of the tracker onto the microscope could lead to an improvement of the accuracy to the order of 0.5 mm. Finally, we describe our clinical experience using the system in the operation room, where three operations have been performed to date.
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Aschke M, Wirtz C, Raczkowsky J, Worn H, Kunze S (2003) Augmented reality in operating microscopes for neurosurgical interventions. In: Proceedings of CAS-H international symposium on computer aided surgery around the head
Baechler R, Bunke H, Nolte LP (2001) Restricted surface matching—numerical optimization and technical evaluation. Comput Aided Surg 6(3):143–152
Birkfellner W, Figl M, Huber K, Watzinger F, Wanschitz F, Hummel J, Hanel R, Greimel W, Homolka P, Ewers R, Bergmann H (2002) A head-mounted operating binocular for augmented reality visualization in medicine–design and initial evaluation. IEEE Trans on Med Imaging 21(8):991–997
Brinker T, Arango G, Kaminsky J, Samii A, Thorns U, Vorkapic P, Samii M (1998) An experimental approach to image guided skull base surgery employing a microscope-based neuronavigation system. Acta Neurochir 140(9):883–889
Edwards P, King A, Maurer C, Cunha D, Hawkes D, Hill D, Gaston R, Fenlon M, Jusczyzck A, Strong A, Chandler C, Gleeson M (2000) Design and evaluation of a system for microscope-assisted guided interventions (magi). IEEE Transactions on Medical Imaging 19:1082–1093
Fichtinger G, Deguet A, Masumane K, Balogh E, Fischer G, Matthieu H, Taylor RH, Zinreich S, Fayad L (2005) Image overlay guidance for needle insertion in ct scanner. IEEE Trans Biomed Eng 52(8):1415–1424
Fitzpatrick West J, Maurer C (1998) Predicting error in rigid-body point-based registration. IEEE Trans Med Imag 17(5):694–702
Grimson W, Ettinger G, White S, Lozano-Perez T, Wells W, Kikinis R (1996) An automatic registration method for frameless stereotaxy, image guided surgery, and enhanced reality visualization. IEEE Trans Med Imaging 15(2):129–140
Hata N, William M, Halle M, Nakajima S, Viola P, Kikinis R, Jolesz F (1996) Image guided microscopic surgery system using mutual-information based registration. In: 4th international conference on visualization in biomedical computing, pp 307–316
Heikkila J, Silven O (1997) A four-step camera calibration procedure with implicit image correction. In: IEEE computer society conference on computer vision and pattern recognition, pp 1106–1112
Khamene A, Wacker F, Vogt S, Azar F, Wendt M, Sauer F, Lewin J (2003) An augmented reality system for mri-guided needle biopsies. In: Proceedings of medicine meets virtual reality, pp 151–157
Kiya N, Dureza C, Fukushima T, Maroon J (1997) Computer navigational microscope for minimally invasive neurosurgery. J Minim Invasive Neurosurg 40(3):110–115
Liao H, Hata N, Nakajima S, Iwahara M, Sakuma I, Dohi T (2004) Surgical navigation by autostereoscopic image overlay of integral videography. IEEE Trans Inform Technol Biomed 8(2):114–121
Maurer C, Fitzpatrick M, Wang M, Galloway R, Maciunas R, Allen G (1997) Registration of head volume images using implantable fiducial markers. IEEE Trans Med Imaging 16:447–461
Salb T, Brief J, Burgert O, Hassfeld S, Mühling J, Dillmann R (1999) An augmented reality system for intraoperative presentation of planning and simulation results. In: Proceedings of workshop: European advanced robotic systems develpment—medical robotics (EUREL), Pisa
Schnaider M, Schwald B, Seibert H, Weller T (2003) Medarpa—a medical augmented reality system for minimal-invasive interventions. In: Proceedings of the 11th annual medicine meets virtual reality (MMVR) conference
Tsai R (1986) An efficient and accurate camera calibration technique for 3D machine vision. In: IEEE conference on computer vision and pattern recognition, Miami Beach, pp 364–374
Veldpaus F, Woltring H, Dortmans L (1988) A least-squares algorithm for the equiform transformation from spatial marker co-ordinates. J Biomech 21:45–54
Weber S, Lüth T (2004) A new navigated image viewer with an integrated position sensor. CAS-H
Zhang Z (1999) Flexible camera calibration by viewing a plane from unknown orientations. In: International conference on computer vision (ICCV’99), Corfu
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Giraldez, J.G., Caversaccio, M., Pappas, I. et al. Design and clinical evaluation of an image-guided surgical microscope with an integrated tracking system. Int J CARS 1, 253–264 (2007). https://doi.org/10.1007/s11548-006-0066-0
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DOI: https://doi.org/10.1007/s11548-006-0066-0