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Biomedical subjects

G P Penney

Publications and source records attributed to G P Penney.

9 recordsLinked to original sources

Tissue deformation and shape models in image-guided interventions: a discussion paper.

This paper promotes the concept of active models in image-guided interventions. We outline the limitations of the rigid body assumption in image-guided interventions and describe how intraoperative imaging provides a rich source of information on spatial location of anatomical structures and therapy devices, allowing a preoperative plan to be updated during an intervention. Soft tissue deformation and variation from an atlas to a particular individual can both be determined using non-rigid registration. Established methods using free-form deformations have a very large number of degrees of freedom. Three examples of deformable models--motion models, biomechanical models and statistical shape models--are used to illustrate how prior information can be used to restrict the number of degrees of freedom of the registration algorithm and thus provide active models for image-guided interventions. We provide preliminary results from applications for each type of model.

Algorithms↗

Registration of freehand 3D ultrasound and magnetic resonance liver images.

We present a method to register a preoperative MR volume to a sparse set of intraoperative ultrasound slices. Our aim is to allow the transfer of information from preoperative modalities to intraoperative ultrasound images to aid needle placement during thermal ablation of liver metastases. The spatial relationship between ultrasound slices is obtained by tracking the probe using a Polaris optical tracking system. Images are acquired at maximum exhalation and we assume the validity of the rigid body transformation. An initial registration is carried out by picking a single corresponding point in both modalities. Our strategy is to interpret both sets of images in an automated pre-processing step to produce evidence or probabilities of corresponding structure as a pixel or voxel map. The registration algorithm converts the intensity values of the MR and ultrasound images into vessel probability values. The registration is then carried out between the vessel probability images. Results are compared to a "bronze standard" registration which is calculated using a manual point/line picking algorithm and verified using visual inspection. Results show that our starting estimate is within a root mean square target registration error (calculated over the whole liver) of 15.4 mm to the "bronze standard" and this is improved to 3.6 mm after running the intensity-based algorithm.

Algorithms↗

Registration-based interpolation.

A method is presented to interpolate between neighboring slices in a grey-scale tomographic data set. Spatial correspondence between adjacent slices is established using a nonrigid registration algorithm based on B-splines which optimizes the normalized mutual information similarity measure. Linear interpolation of the image intensities is then carried out along the directions calculated by the registration algorithm. The registration-based method is compared to both standard linear interpolation and shape-based interpolation in 20 tomographic data sets. Results show that the proposed method statistically significantly outperforms both linear and shape-based interpolation.

Algorithms↗

Assessment of a technique for 2D-3D registration of cerebral intra-arterial angiography.

This study assesses the ability of a computer algorithm to perform automated 2D-3D registrations of digitally subtracted cerebral angiograms. The technique was tested on clinical studies of five patients with intracranial aneurysms. The automated procedure was compared against a gold standard manual registration, and achieved a mean registration accuracy of 1.3 mm (SD 0.6 mm). Two registration strategies were tested using coarse (128 x 128 pixel) or fine (256 x 256 pixel) images. The mean registration errors proved similar but registration of the lower resolution images was 3 times quicker (mean registration times 33 s, SD 13 s for low and 150 s SD 48 s for high resolution images). The automated techniques were considerably faster than manual registrations but achieved similar accuracy. The technique has several potential uses but is particularly applicable to endovascular treatment techniques.

Algorithms↗

Deforming a preoperative volume to represent the intraoperative scene.

Soft-tissue deformation can be a problem if a preoperative modality is used to help guide a surgical or interventional procedure. We present a method that can warp a preoperative CT image to represent the intraoperative scene shown by an interventional fluoroscopy image. The method is a novel combination of a 2D-3D image registration algorithm and a deformation algorithm that allows rigid bodies to be incorporated into a nonlinear deformation based on radial basis functions. The 2D-3D registration algorithm is used to obtain information on relative vertebral movements between preoperative and intraoperative images. The deformation algorithm uses this information to warp the preoperative image to represent the intraoperative scene more accurately. Images from an aortic stenting procedure were used. The observed deformation in our experiment was 5 degrees flexion and 5 mm lengthening of the lumbar spine over a distance of four vertebrae. The vertebral positions in the warped CT volume represent the intraoperative scene more accurately than in the preoperative CT volume. Although we had no gold standard with which to assess the registration accuracy of soft-tissue structures, the position of such structures within the warped CT volume appeared visually realistic.

Algorithms↗

Validation of a two- to three-dimensional registration algorithm for aligning preoperative CT images and intraoperative fluoroscopy images.

We present a validation of an intensity based two- to three-dimensional image registration algorithm. The algorithm can register a CT volume to a single-plane fluoroscopy image. Four routinely acquired clinical data sets from patients who underwent endovascular treatment for an abdominal aortic aneurysm were used. Each data set was comprised of two intraoperative fluoroscopy images and a preoperative CT image. Regions of interest (ROI) were drawn around each vertebra in the CT and fluoroscopy images. Each CT image ROI was individually registered to the corresponding ROI in the fluoroscopy images. A cross validation approach was used to obtain a measure of registration consistency. Spinal movement between the preoperative and intraoperative scene was accounted for by using two fluoroscopy images. The consistency and robustness of the algorithm when using two similarity measures, pattern intensity and gradient difference, was investigated. Both similarity measures produced similar results. The consistency values were rotational errors below 0.74 degree and in-plane translational errors below 0.90 mm. These errors approximately relate to a two-dimensional projection error of 1.3 mm. The failure rate was less than 8.3% for three of the four data sets. However, for one of the data sets a much larger failure rate (28.5%) occurred.

Algorithms↗

A comparison of similarity measures for use in 2-D-3-D medical image registration.

A comparison of six similarity measures for use in intensity-based two-dimensional-three-dimensional (2-D-3-D) image registration is presented. The accuracy of the similarity measures are compared to a "gold-standard" registration which has been accurately calculated using fiducial markers. The similarity measures are used to register a computed tomography (CT) scan of a spine phantom to a fluoroscopy image of the phantom. The registration is carried out within a region-of-interest in the fluoroscopy image which is user defined to contain a single vertebra. Many of the problems involved in this type of registration are caused by features which were not modeled by a phantom image alone. More realistic "gold-standard" data sets were simulated using the phantom image with clinical image features overlaid. Results show that the introduction of soft-tissue structures and interventional instruments into the phantom image can have a large effect on the performance of some similarity measures previously applied to 2-D-3-D image registration. Two measures were able to register accurately and robustly even when soft-tissue structures and interventional instruments were present as differences between the images. These measures were pattern intensity and gradient difference. Their registration accuracy, for all the rigid-body parameters except for the source to film translation, was within a root-mean-square (rms) error of 0.54 mm or degrees to the "gold-standard" values. No failures occurred while registering using these measures.

Algorithms↗

The EASI project--improving the effectiveness and quality of image-guided surgery.

In recent years, advances in computer technology and a significant increase in the accuracy of medical imaging have made it possible to develop systems that can assist the clinician in diagnosis, planning, and treatment. This paper deals with an area that is generally referred to as computer-assisted surgery, image-directed surgery, or image-guided surgery. We report the research, development, and clinical validation performed since January 1996 in the European Applications in Surgical Interventions (EASI) project, which is funded by the European Commission in their "4th Framework Telematics Applications for Health" program. The goal of this project is the improvement of the effectiveness and quality of image-guided neurosurgery of the brain and image-guided vascular surgery of abdominal aortic aneurysms, while at the same time reducing patient risks and overall cost. We have developed advanced prototype systems for preoperative surgical planning and intraoperative surgical navigation, and we have extensively clinically validated these systems. The prototype systems and the clinical validation results are described in this paper.

Quality of Health Care↗

Voxel-based 2-D/3-D registration of fluoroscopy images and CT scans for image-guided surgery.

Registration of intraoperative fluoroscopy images with preoperative three-dimensional (3-D) CT images can be used for several purposes in image-guided surgery. On the one hand, it can be used to display the position of surgical instruments, which are being tracked by a localizer, in the preoperative CT scan. On the other hand, the registration result can be used to project preoperative planning information or important anatomical structures visible in the CT image onto the fluoroscopy image. For this registration task, a novel voxel-based method in combination with a new similarity measure (pattern intensity) has been developed. The basic concept of the method is explained at the example of two-dimensional (2-D)/3-D registration of a vertebra in an X-ray fluoroscopy image with a 3-D CT image. The registration method is described, and the results for a spine phantom are presented and discussed. Registration has been carried out repeatedly with different starting estimates to study the capture range. Information about registration accuracy has been obtained by comparing the registration results with a highly accurate "ground-truth" registration, which has been derived from fiducial markers attached to the phantom prior to imaging. In addition, registration results for different vertebrae have been compared. The results show that the rotation parameters and the shifts parallel to the projection plane can accurately be determined from a single projection. Because of the projection geometry, the accuracy of the height above the projection plane is significantly lower.

Fluoroscopy↗