Georgios Sakas

EU-TeleInViVo: an integrated portable telemedicine workstation featuring acquisition, processing and transmission over low-bandwidth lines of 3D ultrasound volume images

A transportable telemedicine workstation has been designed, developed and evaluated for use in isolated areas such as islands, rural areas and crisis situation areas. The EU-TeleInViVo is a custom-made device integrating in one solid case: a portable PC with telecommunication capabilities and a light, portable 3D ultrasound station. The system developed has low price, low weight, is transportable and non-radiating. The integrated workstation uses advanced software techniques to acquire 3-dimensional ultrasound data of a patient. The device is now being tested in different socioeconomic conditions and adjusted accordingly to meet needs of developing countries and countries in transition. It currently comes in two versions, one fully portable, self-contained device, and a workstation version (PC attached to an ultrasound scanner for internal hospital use). A dedicated software package has been developed for the needs of this project, based on the InVivoScanNT software package developed at Fraunhofer IGD. During a teleconsultation, both partners, connected over a telecommunications network, are able to share the same interface and perform tasks visible in real time, even on low bandwidth channels, to both ends on the same data set. The system supports various ways of communication, such as Internet, ISDN, common phone lines, GSM, etc.

Minimally Invasive Multiport Surgery of the Lateral Skull Base

Objective. Minimally invasive procedures minimize iatrogenic tissue damage and lead to a lower complication rate and high patient satisfaction. To date only experimental minimally invasive single-port approaches to the lateral skull base have been attempted. The aim of this study was to verify the feasibility of a minimally invasive multiport approach for advanced manipulation capability and visual control and develop a software tool for preoperative planning. Methods. Anatomical 3D models were extracted from twenty regular temporal bone CT scans. Collision-free trajectories, targeting the internal auditory canal, round window, and petrous apex, were simulated with a specially designed planning software tool. A set of three collision-free trajectories was selected by skull base surgeons concerning the maximization of the distance to critical structures and the angles between the trajectories. Results. A set of three collision-free trajectories could be successfully simulated to the three targets in each temporal bone model without violating critical anatomical structures. Conclusion. A minimally invasive multiport approach to the lateral skull base is feasible. The developed software is the first step for preoperative planning. Further studies will focus on cadaveric and clinical translation.

Feature Extraction from Medical Images for an Oral Cancer Reoccurrence Prediction Environment

We present the concept of a novel image feature extraction approach that will be used to predict oral cancer reoccurrence in the scope of the NeoMark project. Based on current clinical practice, we propose several numeric image features that characterize tumors and lymph nodes. In order to (semi) automatically extract those features we introduce the following approach which is independent from human subjectivity: Registration and supervised segmentation of CT/MR images forms the base of the automated extraction of geometric and texture features of tumors and lymph nodes. In order to reduce the amount of user interaction during follow ups we incorporate the segmentation results of the previous examinations. The robustness and the numeric manner of the extracted features make them ideally suited as input for a sophisticated adaptive prediction environment that estimates the likelihood of oral cancer reoccurrence and assists the clinician to develop a treatment plan.

Visual Comparison of 3D Medical Image Segmentation Algorithms Based on Statistical Shape Models

3D medical image segmentation is needed for diagnosis and treatment. As manual segmentation is very costly, automatic segmentation algorithms are needed. For finding best algorithms, several algorithms need to be evaluated on a set of organ instances. This is currently difficult due to dataset size and complexity.

Path Planning for Multi-port Lateral Skull Base Surgery Based on First Clinical Experiences

Our research project investigates a multi-port minimally-traumatic approach for lateral skull base surgery, where the surgical target shall be reached through up to three drill canals. For this purpose, an accurate path planning is crucial. In the present work, we propose a semi-automatic path planning approach for multi-port minimally-traumatic lateral skull base surgery. The best path combinations are automatically determined by optimizing the angles and distance buffers of the drill canals. We compare the automatically computed path combinations for 20 data sets to those selected manually by two different clinicians. The experiments prove that we can adequately reproduce the clinicians’ choice.

A portable medical unit for medical imaging telecollaboration

In this paper, we are going to introduce a multimodal portable medical device for both medical imaging tele-collaboration and monitoring of vital parameters. The introduced portable unit offers diversity of medical devices and is in position to acquire ultrasound images, ECG 12 leads, and blood pressure and be able to measure oxygen level in the blood. In addition, the portable unit is equipped with all available telecommunication gateways (e.g. GSM, UMTS, ISDN, DSL, Satellite) providing a great communication convenience to the physicians utilizing XMMP instant messaging protocols.