Erwan Kerrien

Image-guided simulation of heterogeneous tissue deformation for augmented reality during hepatic surgery

This paper presents a method for real-time augmentation of vascular network and tumors during minimally invasive liver surgery. Internal structures computed from pre-operative CT scans can be overlaid onto the laparoscopic view for surgery guidance. Compared to state-of-the-art methods, our method uses a real-time biomechanical model to compute a volumetric displacement field from partial three-dimensional liver surface motion. This permits to properly handle the motion of internal structures even in the case of anisotropic or heterogeneous tissues, as it is the case for the liver and many anatomical structures. Real-time augmentation results are presented on in vivo and phantom data and illustrate the benefits of such an approach for minimally invasive surgery.

Model of a vascular C-arm for 3D augmented fluoroscopy in interventional radiology

This paper deals with the modeling of a vascular C-arm to generate 3D augmented fluoroscopic images in an interventional radiology context. A methodology based on the use of a multi-image calibration is proposed to assess the physical behavior of the C-arm. From the knowledge of the main characteristics of the C-arm, realistic models of the acquisition geometry are proposed. Their accuracy was evaluated and experiments showed that the C-arm geometry can be predicted with a mean 2D reprojection error of 0.5 mm. The interest of 3D augmented fluoroscopy is also assessed on a clinical case.

Machine precision assessment in 3D/2D digital subtracted angiography image registration

During an interventional neuroradiology exam, knowing the exact location of the catheter tip with respect to the patient can dramatically help the physician. An image registration between digital subtracted angiography (DSA) images and a volumic pre-operative image (magnetic resonance or computed tomography volumes) is a way to infer this important information. This mono-patient multimodality matching can be reduced to finding the projection matrix that transforms any voxel of the volume onto the DSA image plane. This modelization is unfortunately not valid in the case of distorted images, which is the case for DSA images. A classical angiography room can now generate 3D X-ray angiography volumes (3DXA). Since the DSA images are obtained with the same machine, it should be possible to deduce the projection matrix from the sensor data indicating the current machine position. We propose an interpolation scheme, associated to a pre-operative calibration of the machine that allows us to correct the distortions in the image at any position used during the exam with a precision of one pixel. Thereafter, we describe some calibration procedures and an associated model of the machine that can provide us with a projection matrix at any position of the machine. Thus, we obtain a machine-based 2D DSA/3DXA registration. The misregistration error can be limited to 2.5 mm if the patient is well centered within the system. This error is confirmed by a validation on a phantom of the vascular tree. This validation also yields that the residual error is a translation in the 3D space. As a consequence, the registration method presented in this paper can be used as an initial guess to an iterative refining algorithm.

Impact of Soft Tissue Heterogeneity on Augmented Reality for Liver Surgery

This paper presents a method for real-time augmented reality of internal liver structures during minimally invasive hepatic surgery. Vessels and tumors computed from pre-operative CT scans can be overlaid onto the laparoscopic view for surgery guidance. Compared to current methods, our method is able to locate the in-depth positions of the tumors based on partial three-dimensional liver tissue motion using a real-time biomechanical model. This model permits to properly handle the motion of internal structures even in the case of anisotropic or heterogeneous tissues, as it is the case for the liver and many anatomical structures. Experimentations conducted on phantom liver permits to measure the accuracy of the augmentation while real-time augmentation on in vivo human liver during real surgery shows the benefits of such an approach for minimally invasive surgery.

Towards Interactive Planning of Coil Embolization in Brain Aneurysms

Many vascular pathologies can now be treated in a minimally invasive way thanks to interventional radiology. Instead of open surgery, it allows to reach the lesion of the arteries with therapeutic devices through a catheter. As a particular case, intracranial aneurysms are treated by filling the localized widening of the artery with a set of coils to prevent a rupture due to the weakened arterial wall. Considering the location of the lesion, close to the brain, and its very small size, the procedure requires a combination of careful planning and excellent technical skills. An interactive and reliable simulation, adapted to the patient anatomy, would be an interesting tool for helping the interventional neuroradiologist plan and rehearse a coil embolization procedure. This paper describes an original method to perform interactive simulations of coil embolization and proposes a clinical metric to quantitatively measure how the first coil fills the aneurysm. The simulation relies on an accurate reconstruction of the aneurysm anatomy and a real-time model of the coil for which sliding and friction contacts are taken into account. Simulation results are compared to real embolization procedure and exhibit good adequacy.

A methodology for validating a 3D imaging modality for brain AVM delineation: Application to 3DRA

A general methodology is described to validate a 3D imaging modality with respect to 2D digital subtracted angiography (DSA) for brain AVMs (BAVM) delineation. It relies on the assessment of the statistical compatibility of the radiosurgical target delineated in 3D with its delineations in 2D. This methodology is demonstrated through a preliminary evaluation of 3D rotational angiography (3DRA). Generally speaking, BAVM delineation cannot be performed on 3DRA alone. However, in our study, 3DRA showed similar performances to DSA for rather easy cases, and even better for three patients. Conversely, three problematic cases are identified and discussed.

A shape-based framework to segmentation of tongue contours from MRI data

We propose a shape-based variational framework to curve evolution for the segmentation of tongue contours from MRI mid-sagittal images. In particular, we first build a PCA model on tongue contours of different articulations of a reference speaker, and use it as shape priors. The parameters of the curve representation are then manipulated to minimize an objective function. The designed energy integrates both global and local image information. The global term extracts roughly the object in the whole image domain; while the local term improves precision inside a small neighborhood around the contour. Promising results and comparisons with other approaches demonstrate the efficiency of our new model.

Physics-based Augmented Reality for 3D Deformable Object

This paper introduces an original method to perform augmented or mixed reality on deformable objects. Compared to state-of-the-art techniques, our method is able to track deformations of volumetric objects and not only surfacic objects. A flexible framework that relies on the combination of a 3D motion estimation and a physics-based deformable model used as a regularization and interpolation step allows to perform a non-rigid and robust registration. Results are exposed, based on computer-generated datasets and video sequences of real environments in order to assess the relevance of our approach.

Towards an accurate tracking of liver tumors for augmented reality in robotic assisted surgery

This article introduces a method for tracking the internal structures of the liver during robot-assisted procedures. Vascular network, tumors and cut planes, computed from pre-operative data, can be overlaid onto the laparoscopic view for image-guidance, even in the case of large motion or deformation of the organ. Compared to current methods, our method is able to precisely propagate surface motion to the internal structures. This is made possible by relying on a fast yet accurate biomechanical model of the liver combined with a robust visual tracking approach designed to properly constrain the model. Augmentation results are demonstrated on in-vivo sequences of a human liver during robotic surgery, while quantitative validation is performed on an ex-vivo porcine liver experimentation. Validation results show that our approach gives an accurate surface registration with an error of less than 6mm on the position of the tumor.

Robust RANSAC-based blood vessel segmentation

Many vascular clinical applications require a vessel segmentation process that is able to extract both the centerline and the surface of the blood vessels. However, noise and topology issues (such as kissing vessels) prevent existing algorithm from being able to easily retrieve such a complex system as the brain vasculature. We propose here a new blood vessel tracking algorithm that 1) detects the vessel centerline; 2) provides a local radius estimate; and 3) extracts a dense set of points at the blood vessel surface. This algorithm is based on a RANSAC-based robust fitting of successive cylinders along the vessel. Our method was validated against the Multiple Hypothesis Tracking (MHT) algorithm on 10 3DRA patient data of the brain vasculature. Over 744 blood vessels of various sizes were considered for each patient. Our results demonstrated a greater ability of our algorithm to track small, tortuous and touching vessels (96% success rate), compared to MHT (65% success rate). The computed centerline precision was below 1 voxel when compared to MHT. Moreover, our results were obtained with the same set of parameters for all patients and all blood vessels, except for the seed point for each vessel, also necessary for MHT. The proposed algorithm is thereafter able to extract the full intracranial vasculature with little user interaction.