International journal of computer assisted radiology and surgery
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Int J Comput Assist Radiol Surg · Jun 2016
Preclinical usability study of multiple augmented reality concepts for K-wire placement.
In many orthopedic surgeries, there is a demand for correctly placing medical instruments (e.g., K-wire or drill) to perform bone fracture repairs. The main challenge is the mental alignment of X-ray images acquired using a C-arm, the medical instruments, and the patient, which dramatically increases in complexity during pelvic surgeries. Current solutions include the continuous acquisition of many intra-operative X-ray images from various views, which will result in high radiation exposure, long surgical durations, and significant effort and frustration for the surgical staff. This work conducts a preclinical usability study to test and evaluate mixed reality visualization techniques using intra-operative X-ray, optical, and RGBD imaging to augment the surgeon's view to assist accurate placement of tools. ⋯ The 3D visualization of patient, tool, and DRR shows clear advantages over the conventional X-ray imaging and provides intuitive feedback to place the medical tools correctly and efficiently.
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Int J Comput Assist Radiol Surg · Apr 2016
Comparative StudyComparison of anterograde versus retrograde percutaneous screw fixation of anterior column acetabular fractures.
Percutaneous screw fixation is an effective technique in addressing minimally displaced anterior column acetabular fractures. The aim of this study is to evaluate the ease of percutaneous screw insertion for acetabular anterior column fracture, as it pertains to anterograde versus retrograde insertion techniques. ⋯ In our analysis, we found two areas for effective percutaneous anterograde insertion and one area for effective retrograde insertion. They both possess geometries with different shapes. Additionally, the area of anterograde insertion is larger than the retrograde area of insertion. The limitations in screw positions were shown in the AP, inlet, outlet, iliac oblique, obturator oblique, and lateral views. The direction range between superior and inferior and between medial and lateral were measured and recorded. In area of anterograde, the angle between the superior and inferior limits was 29.2° ± 2.7°, while the angle limit between medial and lateral was 18.5° ± 1.8°. In area of retrograde, the angle between the superior and inferior limits was 8.32° ± 1.3°, while the angle limit between medial and lateral was 7.5° ± 0.8°
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Int J Comput Assist Radiol Surg · Jan 2016
A technique for semiautomatic segmentation of echogenic structures in 3D ultrasound, applied to infant hip dysplasia.
Automatic segmentation of anatomical structures and lesions from medical ultrasound images is a formidable challenge in medical imaging due to image noise, blur and artifacts. In this paper we present a segmentation technique with features highly suited to use in noisy 3D ultrasound volumes and demonstrate its use in modeling bone, specifically the acetabulum in infant hips. Quantification of the acetabular shape is crucial in diagnosing developmental dysplasia of the hip (DDH), a common condition associated with hip dislocation and premature osteoarthritis if not treated. The well-established Graf technique for DDH diagnosis has been criticized for high inter-observer and inter-scan variability. In our earlier work we have introduced a more reliable instability metric based on 3D ultrasound data. Visualizing and interpreting the acetabular shape from noisy 3D ultrasound volumes has been one of the major roadblocks in using 3D ultrasound as diagnostic tool for DDH. For this study we developed a semiautomated segmentation technique to rapidly generate 3D acetabular surface models and classified the acetabulum based on acetabular contact angle (ACA) derived from the models. We tested the feasibility and reliability of the technique compared with manual segmentation. ⋯ The semiautomatic segmentation technique proposed in this work offers a fast and reliable method to delineate the contours of the acetabulum from 3D ultrasound volumes of the hip. Since the technique does not rely upon contour evolution, it is less susceptible than other methods to the frequent missing or incomplete boundaries and noise artifacts common in ultrasound images. ACA derived from the segmented 3D surface was able to accurately classify the acetabulum under the categories normal, borderline and dysplastic. The semiautomatic technique makes it easier to segment the volume and reduces the inter-observer and intra-observer variation in ACA calculation compared with manual segmentation. The method can be applied to any structure with an echogenic boundary on ultrasound (such as a ventricle, blood vessel, organ or tumor), or even to structures with a bright border on computed tomography or magnetic resonance imaging.
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Int J Comput Assist Radiol Surg · Nov 2015
Operator experience determines performance in a simulated computer-based brain tumor resection task.
Develop measures to differentiate between experienced and inexperienced neurosurgeons in a virtual reality brain surgery simulator environment. ⋯ Virtual Reality brain surgery can differentiate operators based on both recent and long-term experience and may be useful in the acquisition and assessment of neurosurgical skills. Coaching alters the learning curve of naïve inexperienced individuals.
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Int J Comput Assist Radiol Surg · Oct 2015
Comparative StudyComparison of 3D C-arm fluoroscopy and 3D image-guided navigation for minimally invasive pelvic surgery.
This study aims to compare the efficacy and accuracy of percutaneous screw fixation using three-dimensional [Formula: see text] navigation and conventional C-arm fluoroscopy in pelvic fracture surgery. ⋯ Percutaneous screw fixation using the [Formula: see text] navigational system minimizes the fluoroscope exposure and screw insertion time, while improving screw insertion accuracy. Moreover, the [Formula: see text] navigational system provided a reliable method for fluoroscopy imaging in pelvic fractures.