TY - JOUR
T1 - Accuracy considerations in image-guided cardiac interventions
T2 - Experience and lessons learned
AU - Linte, Cristian A.
AU - Lang, Pencilla
AU - Rettmann, Maryam E.
AU - Cho, Daniel S.
AU - Holmes, David R.
AU - Robb, Richard A.
AU - Peters, Terry M.
N1 - Funding Information:
Acknowledgments The authors thank Dr. Daniel Bainbridge, Dr. Gérard Guiraudon, Dr. Michael Chu, Dr. Bob Kiaii, Dr. Douglas Jones, and Dr. Douglas Packer for sharing their clinical insight and John Moore, Chris Wedlake, Jaques Milner, Dr. Elvis Chen, Dr. Usaf Aladl, Dr. Andrew Wiles, Jon Camp, Ron Kawroski, and Bruce Cam-eron for helpful discussions and technical support. We also acknowledge the funding for this work provided by the Natural Sciences and Engineering Research Council of Canada, Canadian Institutes of Health Research, Heart & Stroke Foundation of Canada, Ontario Research Fund, Ontario Innovation Trust, Canada Foundation for Innovation, and grant EB002834 from the National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health.
PY - 2012/1
Y1 - 2012/1
N2 - Motivation Medical imaging and its application in interventional guidance has revolutionized the development of minimally invasive surgical procedures leading to reduced patient trauma, fewer risks, and shorter recovery times. However, a frequently posed question with regard to an image guidance system is "how accurate is it?" On one hand, the accuracy challenge can be posed in terms of the tolerable clinical error associated with the procedure; on the other hand, accuracy is bound by the limitations of the system's components, including modeling, patient registration, and surgical instrument tracking, all of which ultimately impact the overall targeting capabilities of the system. Methods While these processes are not unique to any interventional specialty, this paper discusses them in the context of two different cardiac image guidance platforms: a modelenhanced ultrasound platform for intracardiac interventions and a prototype system for advanced visualization in imageguided cardiac ablation therapy. Results Pre-operative modeling techniques involving manual, semi-automatic and registration-based segmentation are discussed. The performance and limitations of clinically feasible approaches for patient registration evaluated both in the laboratory and in the operating room are presented. Our experience with two different magnetic tracking systems for instrument and ultrasound transducer localization is reported. Ultimately, the overall accuracy of the systems is discussed based on both in vitro and preliminary in vivo experience. Conclusion While clinical accuracy is specific to a particular patient and procedure and vastly dependent on the surgeon's experience, the system's engineering limitations are critical to determine whether the clinical requirements can be met.
AB - Motivation Medical imaging and its application in interventional guidance has revolutionized the development of minimally invasive surgical procedures leading to reduced patient trauma, fewer risks, and shorter recovery times. However, a frequently posed question with regard to an image guidance system is "how accurate is it?" On one hand, the accuracy challenge can be posed in terms of the tolerable clinical error associated with the procedure; on the other hand, accuracy is bound by the limitations of the system's components, including modeling, patient registration, and surgical instrument tracking, all of which ultimately impact the overall targeting capabilities of the system. Methods While these processes are not unique to any interventional specialty, this paper discusses them in the context of two different cardiac image guidance platforms: a modelenhanced ultrasound platform for intracardiac interventions and a prototype system for advanced visualization in imageguided cardiac ablation therapy. Results Pre-operative modeling techniques involving manual, semi-automatic and registration-based segmentation are discussed. The performance and limitations of clinically feasible approaches for patient registration evaluated both in the laboratory and in the operating room are presented. Our experience with two different magnetic tracking systems for instrument and ultrasound transducer localization is reported. Ultimately, the overall accuracy of the systems is discussed based on both in vitro and preliminary in vivo experience. Conclusion While clinical accuracy is specific to a particular patient and procedure and vastly dependent on the surgeon's experience, the system's engineering limitations are critical to determine whether the clinical requirements can be met.
KW - Clinical and engineering accuracy considerations
KW - Medical imaging and modeling
KW - Minimally invasive cardiac interventions
KW - Registration
KW - Surgical tracking
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U2 - 10.1007/s11548-011-0621-1
DO - 10.1007/s11548-011-0621-1
M3 - Article
C2 - 21671097
AN - SCOPUS:84857623933
SN - 1861-6410
VL - 7
SP - 13
EP - 25
JO - International Journal of Computer Assisted Radiology and Surgery
JF - International Journal of Computer Assisted Radiology and Surgery
IS - 1
ER -