Experimental validation of predicted application accuracies for computer-assisted (CAS) intraoperative navigation with paired-point registration

Perwög, Martina; Bárdosi, Z; Freysinger, Wolfgang

doi:10.1007/s11548-017-1653-y

Cited by 9 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As already confirmed by other studies (e.g. see [8, 10, 22]), a smaller number of fiducials lead to a larger TRE than using more fiducials for registration. However, using, for example, 5 fiducials is not necessarily leading to a larger TRE than using 10 fiducials.…”

Section: Discussionsupporting

confidence: 79%

Probe versus microscope: a comparison of different methods for image-to-patient registration

et al. 2018

Self Cite

View full text Add to dashboard Cite

PurposeComputer-aided navigation is widely used in ENT surgery. The position of a surgical instrument is shown in the CT/MR images of the patient and can thus be a good support for the surgeon. The accuracy is highly dependent on the registration done prior to surgery. A microscope and a probe can both be used for registration and navigation, depending on the surgical intervention. A navigation system typically only reports the fiducial registration error after paired-point registration. However, the target registration error (TRE)—a measurement for the accuracy in the surgical area—is much more relevant. The aim of this work was to compare the performance of a microscope relative to a conventional probe-based approach with different registration methods.MethodsIn this study, optical tracking was used to register a plastic skull to its preoperative CT images with paired-point registration. Anatomical landmarks and skin-affixed markers were used as fiducials and targets. With both microscope and probe, four different registration methods were evaluated based on their TREs at 10 targets. For half of the experiments, a surface registration and/or external fiducials were used additionally to paired-point registration to study their influence to accuracy.ResultsOverall, probe registration leads to a smaller TRE () than registration with a microscope (). Additional surface registration does not result in better accuracy of navigation for microscope and probe. The lowest mean TRE for both pointers can be achieved with paired-point registration only and radiolucent markers.ConclusionOur experiments showed that a probe used for registration and navigation achieves lower TREs compared using a microscope. Neither additional surface registration nor additional fiducials on an external reference element are necessary for improved accuracy of navigated ENT surgery on a plastic skull.

show abstract

Section: Discussionsupporting

confidence: 79%

Probe versus microscope: a comparison of different methods for image-to-patient registration

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…Manual paired‐point registration for navigated ears, nose, and throat (ENT) surgery is prone to human errors localizing registration markers in the diagnostic images and on the patient, respectively. The procedure can be automated through surface registration with intraoperatively acquired data; however, the state‐of‐the‐art algorithms either converge locally, or rely on expensive brute force computation…”

Section: Introductionmentioning

confidence: 99%

Vector field analysis for surface registration in computer‐assisted ENT surgery

Diakov

Freysinger

2019

Robotics Computer Surgery

Self Cite

View full text Add to dashboard Cite

Background Manual paired‐point registration for navigated ENT‐surgery is prone to human errors; automatic surface registration is often caught in local minima. Methods Anatomical features of the human occiput are integrated into an algorithm for surface registration. A vector force field is defined between the patient and operating room datasets; registration is facilitated through gradient‐based vector field analysis optimization of an energy function. The method is validated exemplarily on patient surface data provided by a mechanically positioned A‐mode ultrasound sensor. Results Successful registrations were achieved within the entire parameter space, as well as from positions of local minima that were found by the Gaussian fields algorithm for surface registration. Sub‐millimetric registration error was measured in clinically relevant anatomical areas on the anterior skull and within the generally accepted margin of 1.5 mm for the entire head. Conclusion The satisfactory behavior of this approach potentially suggests a wider clinical integration.

show abstract

“…Anatomical landmarks are also defined without pre-CT fiducial positioning. Target registration error (TRE) served as outcome parameter for accuracy [19,20]. Position of 16 targets and performance of 4 operators were included as random factors.…”

Section: Discussionmentioning

confidence: 99%

“…The pointer was not always aimed at the center of the screw head at an exact 90º angle. A wider surface contact and an eccentric location of the actual instrument's tip may result in loss of pointing accuracy [20].…”

Section: User Localization and Fiducial Localization Errormentioning

confidence: 99%

Accuracy of surface registration in cranial electromagnetic navigation

Runge¹,

Steinbichler²,

Giotakis³

et al. 2018

Otorhinolaryngol Head Neck Sur

Self Cite

View full text Add to dashboard Cite

Purpose: We evaluated the accuracy of surface registration with and without additional landmark registration during cranial electromagnetic navigation. Results were referenced to point by point registration with bone anchored fiducials. Methods:Using a commercially available electromagnetic navigation system, 4 rhinologic surgeons applied surface registration alone (SurfReg) and surface registration with additional anatomic landmarks (CombReg) in a macerated human skull. Point by point registration using bone anchored fiducials (RefReg) served as reference. Target registration error (TRE) served as a measure for accuracy. For TRE calculation, 16 landmarks on the viscerocranium, the frontal skull base and the middle cranial fossa were touched with a probe and the distance of the probe and the target was measured on a screenshot of the corresponding CT image in three planes. A mixed regression model with registration mode as fixed factor and examiner and target as random factors was used.Results: Mean (95% CI) TRE for SurfReg was 1.12 (0.86 to 1.39) mm and 1.21 (0.94 to 1.47) mm for CombReg (p=0.13). TRE of the RefReg was significantly lower (0.91 mm; 0.64 to 1.18; p<0.001). TRE varied significantly depending on target screw position. TRE did not vary significantly among different examiners. Conclusion:Surface registration is considered sufficiently accurate for clinical application during FESS and frontal skull base surgery. Additional landmarks did not improve accuracy when compared with surface registration alone. Additional time for landmark registration can therefore be spared.

show abstract

Experimental validation of predicted application accuracies for computer-assisted (CAS) intraoperative navigation with paired-point registration

Cited by 9 publications

References 33 publications

Probe versus microscope: a comparison of different methods for image-to-patient registration

Probe versus microscope: a comparison of different methods for image-to-patient registration

Vector field analysis for surface registration in computer‐assisted ENT surgery

Accuracy of surface registration in cranial electromagnetic navigation

Contact Info

Product

Resources

About