Image-Guided Surgery Applications Julien Jomier The University of

Image-Guided Surgery Applications Julien Jomier The University of North Carolina at Chapel Hill IGT Meeting – CADDLab – November, 2005

Outline ● ● TIPS Procedure CASILab Neuro. Surgery Application Brain. Lab Liver Transplant Planning RF Liver Tumor Ablation CADDLab IGT Meeting – CADDLab – November, 2005

TIPS Procedure • Transjugular Intrahepatic Portosystemic Shunt • CASILab @ UNC (Dr. Bullitt) IGT Meeting – CADDLab – November, 2005

TIPS procedure • Biplane Fluoroscopic Images • 3 D/2 D Model-to-Image Registration • Real-time tracking IGT Meeting – CADDLab – November, 2005

TIPS : Registration Fluoro Images Model-to. Image Registration 3 D Vascular Model Balloon Tracking 3 D Display Needle Tracking IGT Meeting – CADDLab – November, 2005

Neuro. Surgery • • • Brain. Lab Vector. Vision/VVLink VTK / CMake Brain/Spine surgery Intra-Operative Ultrasound Optical Tracker (NDI) IGT Meeting – CADDLab – November, 2005

Neuro. Surgery • VVCranial • MR/Patient registration: - Surface matching of the skull • Surgical Navigation • Tool tracking • Head tracking IGT Meeting – CADDLab – November, 2005

MR/US Fusion • Manual alignment of tumor margins • Add automatic nonrigid registration • Model-to-Image registration IGT Meeting – CADDLab – November, 2005

Liver Transplant Planning • Define optimal cutting path preoperatively. • Open-Surgery • Bring the path in the OR • Deformable Registration • Ultrasound Annotation IGT Meeting – CADDLab – November, 2005

Liver Transplant Planning IGT Meeting – CADDLab – November, 2005

Liver Transplant Planning IGT Meeting – CADDLab – November, 2005

RF Liver Tumor Ablation • 40 -50% of all lesions not seen using ultrasound. • Options: - Open Surgery - CT/MR guided RFA - wait until lesion enlarges • Ideal: Percutaneous treatment using US IGT Meeting – CADDLab – November, 2005

RF Liver Tumor Ablation IGT Meeting – CADDLab – November, 2005

RF Liver Tumor Ablation • US Probe tracking via Ascension Flock of Birds • Needle segmentation from US • 3 Displays: - 3 D - Needle point of view - Slice based IGT Meeting – CADDLab – November, 2005

RFA Results • US/MR model-toimage affine registration • About 2 seconds • Accuracy: - < 2 mm translation - < 0. 06 rad rotation IGT Meeting – CADDLab – November, 2005

3 D US Reconstruction • Reconstruct 3 D Ultrasound volume from 2 D tracked images • Breathing/Heart beating • Calibration needed IGT Meeting – CADDLab – November, 2005

3 D US Calibration y Ttracker Tracker -x z TTracker. To. Probe Tmodel -z US Probe y x O TProbe. To. Image US Image IGT Meeting – CADDLab – November, 2005

US Reconstruction Results IGT Meeting – CADDLab – November, 2005

Acknowledgments • • • Dr. Sue Weeks Dr. Friedman Dr. Elizabeth Bullitt Stephen Aylward Amael Delaunoy IGT Meeting – CADDLab – November, 2005

Tools • Open Source Toolkits • ITK/VTK • IGSTK • CMake • SOViewers • FLTK/Qt IGT Meeting – CADDLab – November, 2005