US-fluoroscopy registration for transcatheter aortic valve implantation

Transcatheter aortic valve implantation is a minimally invasive alternative to open-heart surgery for aortic stenosis in which a stent-based bioprosthetic valve is delivered into the heart on a catheter. Limited visualization during this procedure can lead to severe complications. Improved visualization can be provided by live registration of transesophageal echo (TEE) and fluoroscopy images intraoperatively. Since the TEE probe is always visible in the fluoroscopy image, it is possible to track it using fiducial-based single-perspective pose estimation. In this study, inherent probe tracking performance was assessed, and TEE to fluoroscopy registration accuracy and robustness were evaluated. Results demonstrated probe tracking errors of below 0.6 mm and 0.2°, a 2-D RMS registration error of 1.5 mm, and a tracking failure rate of below 1%. In addition to providing live registration and better accuracy and robustness compared to existing TEE probe tracking methods, this system is designed to be suitable for clinical use. It is fully automatic, requires no additional operating room hardware, does not require intraoperative calibration, maintains existing procedure and imaging workflow without modification, and can be implemented in all cardiac centers at extremely low cost.     

Intraoperative laparoscope augmentation for port placement and resection planning in minimally invasive liver resection

In recent years, an increasing number of liver tumor indications were treated by minimally invasive laparoscopic resection. Besides the restricted view, two major intraoperative issues in laparoscopic liver resection are the optimal planning of ports as well as the enhanced visualization of (hidden) vessels, which supply the tumorous liver segment and thus need to be divided (e.g., clipped) prior to the resection. We propose an intuitive and precise method to plan the placement of ports. Preoperatively, self-adhesive fiducials are affixed to the patient's skin and a computed tomography (CT) data set is acquired while contrasting the liver vessels. Immediately prior to the intervention, the laparoscope is moved around these fiducials, which are automatically reconstructed to register the patient to its preoperative imaging data set. This enables the simulation of a camera flight through the patient's interior along the laparoscope's or instruments' axes to easily validate potential ports. Intraoperatively, surgeons need to update their surgical planning based on actual patient data after organ deformations mainly caused by application of carbon dioxide pneumoperitoneum. Therefore, preoperative imaging data can hardly be used. Instead, we propose to use an optically tracked mobile C-arm providing cone-beam CT imaging capability intraoperatively. After patient positioning, port placement, and carbon dioxide insufflation, the liver vessels are contrasted and a 3-D volume is reconstructed during patient exhalation. Without any further need for patient registration, the reconstructed volume can be directly augmented on the live laparoscope video, since prior calibration enables both the volume and the laparoscope to be positioned and oriented in the tracking coordinate frame. The augmentation provides the surgeon with advanced visual aid for the localization of veins, arteries, and bile ducts to be divided or sealed.     

Real time 3D visualization of intraoperative organ deformations using structured dictionary

Restricted visualization of the surgical field is one of the most critical challenges for minimally invasive surgery (MIS). Current intraoperative visualization systems are promising. However, they can hardly meet the requirements of high resolution and real time 3D visualization of the surgical scene to support the recognition of anatomic structures for safe MIS procedures. In this paper, we present a new approach for real time 3D visualization of organ deformations based on optical imaging patches with limited field-of-view and a single preoperative scan of magnetic resonance imaging (MRI) or computed tomography (CT). The idea for reconstruction is motivated by our empirical observation that the spherical harmonic coefficients corresponding to distorted surfaces of a given organ lie in lower dimensional subspaces in a structured dictionary that can be learned from a set of representative training surfaces. We provide both theoretical and practical designs for achieving these goals. Specifically, we discuss details about the selection of limited optical views and the registration of partial optical images with a single preoperative MRI/CT scan. The design proposed in this paper is evaluated with both finite element modeling data and ex vivo experiments. The ex vivo test is conducted on fresh porcine kidneys using 3D MRI scans with 1.2 mm resolution and a portable laser scanner with an accuracy of 0.13 mm. Results show that the proposed method achieves a sub-3 mm spatial resolution in terms of Hausdorff distance when using only one preoperative MRI scan and the optical patch from the single-sided view of the kidney. The reconstruction frame rate is between 10 frames/s and 39 frames/s depending on the complexity of the test model.     

Computer-assisted transurethral laser resection of the prostate (CALRP): theoretical and experimental motion plan

Computer-Assisted transurethral laser resection of the prostate (CALRP) is a treatment modality that was designed and developed based on an integrated system of computer, robotics and laser technology in association with a minimally invasive surgery known as laser transurethral resection of the prostate (LRP). CALRP possesses complementary capabilities that could remedy many of the problems faced by surgeons in conventional LRP by delivering a treatment with repeatability and reliability. The work deals primarily in determining the feasibility study of the computer-assisted lasing motion plan (planned motion sequence controlled by a program) for LRP. A theoretical motion plan that analyzes numerically the lasing motion of the fiber was designed by calculating the profile removal rate and in vitro experiments conducted on human cadaveric prostate to verify and validate the designed motion plan. The novel motion plan, which was executed experimentally using the LaserTrode lightguide, accomplished the objective of resecting the enlarged prostate with the aid of computer and robotics technology.     

基于距离分辨的激光雷达技术研究进展

激光雷达是对空间目标进行远距离高精度探测、跟踪监视的重要技术手段之一,基于距离分辨的激光雷达探测系统相比于传统的成像系统,具有整体结构简单、受大气干扰小等特点。国内外研究机构对该技术领域开展了大量研究,主要介绍了高分辨率回波探测及反射断层成像激光雷达的发展现状,总结和比较了国内外在理论算法、仿真分析、实验测试及实际应用等方面的进展,分析了二者的技术特点,展望了其发展前景。     

Acoustic holography

In the middle and late 1960s, holography, applied to acoustics, generated a considerable upsurge of activity in the already mature acoustic imaging technology. It brought both coherent optics and digital data processing to bear upon the problems of acoustic imaging and introduced fresh approaches to the visualization of sound fields. These developments are reviewed and the wide range of potential applications for acoustic holography is discussed. In most cases, the status is that of proved feasibility awaiting broader application.     

RF field visualization of RF ablation at the Larmor frequency

Radio-frequency ablation (RFA) is an effective minimally invasive treatment for tumors. One primary source of difficulty is monitoring and controlling the ablation region. Currently, RFA is performed at 460 kHz, for which magnetic resonance imaging (MRI) could play a role given its capability for temperature monitoring and tumor visualization. If instead the ablation were to be performed at the MRI Larmor frequency, then the MR capability for B(1) field mapping could be used to directly visualize the radio-frequency (RF) fields created by the ablation currents. Visualizing the RF fields may enable better control of the ablation currents, enabling better control of lesion shape and size and improving repeatability. We demonstrate the feasibility of performing RFAs at 64 MHz and show preliminary results from imaging the RF fields from the ablation. The post-ablation RF fields show an increase in current density in the ablated region, consistent with an increase in conductivity of the ablated tissue.     

Design, Performance, and Applications of a Hybrid X-Ray/MR System for Interventional Guidance

Image-guided minimally invasive procedures have made a substantial impact in improving patient management, reducing the cost, morbidity, and mortality of treatments and making therapies available to patients who would otherwise have no option. X-ray fluoroscopy and magnetic resonance imaging (MRI) are two powerful tools for guiding interventional procedures but with very different strengths and weaknesses. X-ray fluoroscopy offers very high spatial and temporal resolution and is excellent for guiding and deploying devices. MRI offers tomographic imaging with complete freedom of plane orientation, outstanding soft tissue discrimination, and the ability to portray physiological responses during treatment. We have shown that it is feasible to fully integrate an X-ray fluoroscopy system into the bore of an interventional MR scanner to provide a single congruent field of view, with integration requiring minor modifications to the flat-panel digital detector, and using a static-anode X-ray tube. Given the limited availability of the MR scanner platform (0.5T GE Signa SP magnet), and the X-ray fluence limitations of the static-anode X-ray tube, we are now investigating the technology developments required to place a rotating-anode digital flat-panel X-ray system immediately adjacent to a closed-bore MRI system. These types of hybrid systems could have enormous impact in the diagnosis and treatment of oncologic, cardiovascular, and other disorders.     

Applications of micromechatronics in minimally invasive surgery

Many surgical procedures are now performed using the techniques of minimally invasive surgery (MIS), in which unnecessary trauma is limited by reducing the size of incisions to less than about 1 cm or by using catheters or endoscopes threaded through vessels, the gastrointestinal tract, or other tubular structures. Micromechatronic technologies have great potential to allow access to regions now inaccessible, or to enhance the surgeon's abilities in applications where current minimally invasive techniques do not permit the full range of human dexterity and perception. Key needs and applications in MIS are identified, and relevant technologies, methods, and systems issues in mechatronics are discussed. The authors' millirobotic system for MIS of the abdomen is used as an example     

Development of a Wireless Sensor Glove for Surgical Skills Assessment

Laparoscopic surgery is a challenging task in minimally invasive surgery, which involves complex instrument control, extensive manual dexterity, and hand-eye coordination. This requires a greater attention to training and skills evaluation. In order to provide a more objective skills assessment method, this paper presents a wireless sensor platform for the capture of laparoscopic hand gesture data and a hidden-Markov-model-based analysis framework for optimal sensor selection and placement. Detailed experimental validation is provided to illustrate how the proposed method can be used to assess surgical performance improvement over repeated training.     

Real-Time 2-D Temperature Imaging Using Ultrasound

We have previously introduced methods for noninvasive estimation of temperature change using diagnostic ultrasound. The basic principle was validated both in vitro and in vivo by several groups worldwide. Some limitations remain, however, that have prevented these methods from being adopted in monitoring and guidance of minimally invasive thermal therapies, e.g., RF ablation and high-intensity-focused ultrasound (HIFU). In this letter, we present first results from a real-time system for 2-D imaging of temperature change using pulse-echo ultrasound. The front end of the system is a commercially available scanner equipped with a research interface, which allows the control of imaging sequence and access to the RF data in real time. A high-frame-rate 2-D RF acquisition mode, M2D, is used to capture the transients of tissue motion/deformations in response to pulsed HIFU. The M2D RF data is streamlined to the back end of the system, where a 2-D temperature imaging algorithm based on speckle tracking is implemented on a graphics processing unit. The real-time images of temperature change are computed on the same spatial and temporal grid of the M2D RF data, i.e., no decimation. Verification of the algorithm was performed by monitoring localized HIFU-induced heating of a tissue-mimicking elastography phantom. These results clearly demonstrate the repeatability and sensitivity of the algorithm. Furthermore, we present in vitro results demonstrating the possible use of this algorithm for imaging changes in tissue parameters due to HIFU-induced lesions. These results clearly demonstrate the value of the real-time data streaming and processing in monitoring, and guidance of minimally invasive thermotherapy.      

Fiducial optimization for minimal target registration error in image-guided neurosurgery

This paper presents new methods for the optimal selection of anatomical landmarks and optimal placement of fiducial markers in image-guided neurosurgery. These methods allow the surgeon to optimally plan fiducial marker locations on routine diagnostic images before preoperative imaging and to intraoperatively select the set of fiducial markers and anatomical landmarks that minimize the expected target registration error (TRE). The optimization relies on a novel empirical simulation-based TRE estimation method built on actual fiducial localization error (FLE) data. Our methods take the guesswork out of the registration process and can reduce localization error without additional imaging and hardware. Our clinical experiments on five patients who underwent brain surgery with a navigation system show that optimizing one marker location and the anatomical landmarks configuration reduced the TRE. The average TRE values using the usual fiducials setup and using the suggested method were 4.7 mm and 3.2 mm, respectively. We observed a maximum improvement of 4 mm. Reducing the target registration error has the potential to support safer and more accurate minimally invasive neurosurgical procedures.     

红外热像仪测温技术发展综述

综述了红外热像仪测温技术的发展,从技术层面剖析了红外热像仪测温存在的问题,介绍了国内外在红外热像测温技术方面的研究热点,同时展望了未来的发展方向.针对红外测温领域中的理论、仪器、标定及应用四大方向进行了较为详细的分析和总结.     

Breaking the optical difraction barrier with nanophotonics - Ultrahigh-resolution bioimaging and biosensing in the subwavelength nanometric range with nanobiophotonic technologies

The main goal of this study is to develop novel fiber-optic-based nanobiophotonics techniques for noninvasive imaging and biosensing optical properties of cellular and tissue samples beyond the diffraction barrier in the subwavelength nanoscale range. The work covers fundamental principles, recent developments, and trends in advanced nanobiophotonics techniques exploited for either minimally invasive diagnostics and imaging in biomedicine at cellular/intracellular level or development of nanosensors and nanostructured materials. Somerecently developed advanced ultrahigh-resolution nanotechnologies such as confocal nanoscopy and fiber-optic-based nanosensors, will also be discussed. These technologies allow one to break the theoretical optical diffraction barrier and to work in the subwavelength nanoscale range     

Locating a catheter transducer in a three-dimensional ultrasoundimaging field

Cardiac procedures rely on fluoroscopy for catheter guidance and visualization. However, fluoroscopy provides poor contrast of myocardial structures and exposes both the patient and health care providers to ionizing radiation. As an alternative to fluoroscopy, real-time three-dimensional (3-D) ultrasound imaging has the potential to provide a safe means for tracking catheter position in 3-D while simultaneously imaging the heart's anatomy. A method is described for locating a catheter-mounted transducer in the 3-D ultrasound imaging field. The distance from the imaging transducer to the catheter transducer is measured by time of flight, while the angular position is determined by a spatial crosscorrelation of the received signals with stored receive profiles. Results from simulations with 20-dB SNR demonstrated a mean accuracy of 0.22 +/- 0.13 mm at a 70-mm range. In vitro testing showed a resolution of 0.23 +/- 0.11 mm at a range of 75 mm and a resolution of 0.47 +/- 0.47 mm at a range of 97 mm. With combined catheter position and imaging, this tracking method has the potential to replace fluoroscopy and enhance interventional procedures.     

贴片机可视化运动仿真系统设计与实现

贴片机在制造过程中,需要进行贴装测试工作,进行这项工作不仅需要消耗基板、元件而且费时费力,对贴片机的调试工作也很麻烦。为了解决以及更多的了解这方面的技术问题,从可视化动态仿真的角度提供新的思路,通过建立贴片机三维模型、实现贴片机可视化运动仿真、对仿真系统进行测试与优化几个方面对贴片机技术进行研究设计,实现了贴片机的可视化运动仿真,使贴片机的工作流程清晰形象的展现出来。     

Miniaturized CMOS Imaging Module with Real-time DSP Technology for Endoscope and Laryngoscope Applications

Miniaturized video camera is a key component in modern medical devices such as endoscopes or other minimally invasive instruments. Here we present a new imaging module which is so small that it can fit through the instrument channels of conventional endoscopes and laryngoscopes. This imaging module includes a 1/18-in. CMOS image sensor and a small integrated lens with field of view of 120°. A Blackfin DSP is used for real-time video processing, including lens distortion compensation, white balance, auto exposure and edge enhancement. The output video signals are displayed on a color LCD monitor. Two white LEDs provide lighting condition. The tip of the imaging module is packaged in a cylinder of diameter 2.5 mm, making many medical applications such as intubation and endoscopy less invasive. It can also be used in machine vision, security and surveillance where small size is important.     

Magnetosensitive E-Skins for Interactive Devices

Electronic skins (e-skins) have established themselves as a versatile technology to restore or enhance human perception, and potentially enable softer robotics. So far, the focus has been mostly on reproducing the traditional functions associated with human skin, such as, temperature, pressure, and chemical detection. New developments have also introduced nonstandard sensing capabilities like magnetic field detection, to spawn the field of magnetosensitive e-skins. Adding a supplementary information channel—an electronic sixth sense—allows humans to utilize the surrounding magnetic fields as stimuli for touchless interactions. Due to their vectorial nature, these stimuli can be used to track motion and orientation in 3D, opening the door to various kinds of gestural control for interactive devices. This approach to tracking provides an alternative or complement to optic-based systems, which usually rely on cameras or infrared emitters, that cannot easily capture fine motion when objects are far from the source or the line-of-sight is obtruded. Here, the background, fabrication techniques, and recent advances of this field are reviewed; covering important aspects like: directional perception, geomagnetic field detection, on-site conditioning, and multimodal approaches. The aim is to give the reader a general perspective and highlight some new avenues of research, toward artificial magnetoception.     

Computer-assisted planning and navigation for corrective distal radius osteotomy, based on pre- and intraoperative imaging

Malunion after a distal radius fracture is very common and if symptomatic, is treated with a so-called corrective osteotomy. In a traditional distal radius osteotomy, the radius is cut at the fracture site and a wedge is inserted in the osteotomy gap to correct the distal radius pose. The standard procedure uses two orthogonal radiographs to estimate the two inclination angles and the dimensions of the wedge to be inserted into the osteotomy gap. However, optimal correction in 3-Dspace requires restoring three angles and three displacements. This paper introduces a new technique that uses preoperative planning based on 3-D images. Intraoperative 3-D imaging is also used after inserting pins with marker tools in the proximal and distal part of the radius and before the osteotomy. Positioning tools are developed to correct the distal radius pose in six degrees of freedom by navigating the pins. The method is accurate ( d 1.2 mm, ? 0.9°, m TRE = 1.7 mm), highly reproducible (SE (d) < 1.0 mm, SE (?) ≤ 1.4°, SE (m) (TRE) = 0.7 mm), and allows intraoperative evaluation of the end result. Small incisions for pin placement and for the osteotomy render the method minimally invasive.