Jin Xue

A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study

Objective To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery. Materials and Methods In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems. Results The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D) virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons. Conclusion The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon’s skills and knowledge, not as a substitute.

A simulator for percutaneous hepatic microwave thermal ablation under ultrasound guidance

Abstract The purpose of this study was to provide a simulation therapy environment for microwave thermal ablation (MWA) under the guidance of ultrasound, and to present an inexpensive and portable simulator built on real patient-based pre-operative computed tomography (CT) data. We established an experimental simulation system for teaching MWA and present the results of a preliminary evaluation of the simulator’s realism and utility for training. The system comprises physical elements of an electromagnetic tracking device and an abdominal phantom, and software elements providing three-dimensional (3D) image processing tools, real-time navigation functions and objective evaluation function module. Details of the novel aspects of this system are presented, including a portable electromagnetic tracking device, adoption of real patient-based pre-operative CT data of liver, operation simulation of MWA, and recording and playback of the operation simulation. Patients with liver cancer were selected for evaluation of the clinical application value of the experimental simulation system. A total of 50 consultant interventional radiologists and 20 specialist registrars in radiology rated the simulator’s hardware reality and overall ergonomics. Results show that the simulator system we describe can be used as a training tool for MWA. It enables training with real patient cases prior to surgery, and it can provide a realistic simulation of the actual procedure.

Application of 3D imaging in the real-time US–CT fusion navigation for minimal invasive tumor therapy

PurposeImage-guided minimally invasive treatment (IG-MIT) has been widely used for local therapy of both benign and malignant tumors. However, precise needle targeting is a very important step in the minimally invasive treatment. Nowadays, minimally invasive treatment is usually performed with the guidance of the two-dimensional (2D) image. The tip of the puncture needle is difficult to place with precise positioning into the three-dimensional (3D) space of the tumor. This study was an experimental ex vivo study in porcine liver and heart samples with internal targets, focusing on the accuracy with the guidance of the real-time 3D imaging using a self-developed real-time ultrasonography and preoperative computed tomography (CT) fusion navigation system for minimal invasive tumor (liver tumor and uterine fibroid) therapy.MethodsThere are thirty porcine liver samples and thirty porcine heart samples used in the experiments. The average weight of the porcine liver samples was 2216.8 g, and the average weight of the porcine heart samples was 510.5 g. We conducted statistical analysis of the experimental results obtained by five medical students and five interventional radiologists.ResultsThe puncture precision of the needle placement under the guidance of 3D imaging was significantly higher than that of the other groups, and the assistant function is more obvious for medical students than that for interventional radiologists

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(p < 0.05)

Three-Dimensional Visualization Technology and Therapy Planning System for Microwave Ablation Therapy of Liver Tumor

(p<0.05). Assistant function of the US–CT fusion imaging is higher than that of the first group too

Integration of the Image-Guided Surgery Toolkit (IGSTK) into the Medical Imaging Interaction Toolkit (MITK)

(p <0.05)