Radio-frequency ablation is a difficult operative task that requires a precise needle positioning in the centre of the pathology. This article presents an augmented reality system for hepatic therapy guidance that superimposes in real-time 3D reconstructions (from CT acquisition) and a virtual model of the needle on external views of a patient. The superimposition of reconstructed models is performed with a 3D/2D registration based on radio-opaque markers stuck on to the patient's skin. The characteristics of the problem (accuracy, robustness and time processing) led us to develop automatic procedures to extract and match the markers and to track the needle in real time. Experimental studies confirmed that our algorithms are robust and reliable. Preliminary experiments conducted on a human abdomen phantom showed that our system is highly accurate (needle positioning error within 3 mm) and enables the surgeon to reach a target in less than 1 minute on average. Our next step will be to perform an in vivo evaluation.
Apart from traditional test and measurement systems where clock synchronization is required, new emerging application areas like SmartGrids and 4G cellular mobile backhaul networks present strong timing constraints in terms of precise time synchronization. Precision Time Protocol (PTP), as defined in IEEE 1588 standard, offers sub-microsecond synchronization using conventional Ethernet networks. Thus, its acceptance is heavily increasing. However, the protocol performance was reduced in large cascaded networks with varying latencies. This drawback was later softened by the second version of the standard with the introduction of the Transparent Clock (TC) device. In this paper, a general overview of PTPv2 and the utilization of TCs is outlined. The main contribution is a new TC architecture for a FPGA-based network device that benefits from reconfigurable devices flexibility.
In the new minimally invasive surgical era, virtual reality, robotics, and image merging have become topics on their own, offering the potential to revolutionize current surgical treatment and assessment. Improved patient care in the digital age seems to be the primary impetus for continued efforts in the field of telesurgery. The progress in endoscopic surgery with regard to telesurgery is manifested by digitization of the pre-, intra-, and postoperative interaction with the patients' surgical disease via computer system integration: so-called Computer Assisted Surgery (CAS). The preoperative assessment can be improved by 3D organ reconstruction, as in virtual colonoscopy or cholangiography, and by planning and practicing surgery using virtual or simulated organs. When integrating all of the data recorded during this preoperative stage, an enhanced reality can be made possible to improve intra-operative patient interactions. CAS allows for increased three-dimensional accuracy, improved precision and the reproducibility of procedures. The ability to store the actions of the surgeon as digitized information also allows for universal, rapid distribution: i.e., the surgeon's activity can be transmitted to the other side of the operating room or to a remote site via high-speed communications links, as was recently demonstrated by our own team during the Lindbergh operation. Furthermore, the surgeon will be able to share his expertise and skill through teleconsultation and telemanipulation, bringing the patient closer to the expert surgical team through electronic means and opening the way to advanced and continuous surgical learning. Finally, for postoperative interaction, virtual reality and simulation can provide us with 4 dimensional images, time being the fourth dimension. This should allow physicians to have a better idea of the disease process in evolution, and treatment modifications based on this view can be anticipated. We are presently determining the accuracy and efficacy of 4 dimensional imaging compared to conventional evaluations.
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