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Thomas, Roy F., William T. Monacci y Eric A. Mair. "Endoscopic Image-Guided Transethmoid Pituitary Surgery". Otolaryngology–Head and Neck Surgery 127, n.º 5 (noviembre de 2002): 409–16. http://dx.doi.org/10.1067/mhn.2002.129821.
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OBJECTIVE: We describe a new endoscopic transethmoid approach for pituitary surgery and to compare it with other surgical techniques. STUDY DESIGN AND SETTING: Eleven patients undergoing pituitary surgery from September 2000 through January 2002 underwent an image-guided endoscopic transethmoid procedure to remove pituitary tumors. Ease of approach, resection, exposure of the surgical field, and operative complications were documented. RESULTS: Endoscopic ethmoidectomy permits enhanced exposure and simplified tumor resection. The use of one nostril to stabilize the endoscope and the other to pass instruments affords a bimanual procedure that avoids the difficulty of small nares and keeping the scope fixed while exchanging instruments. Operative morbidity was low with no significant complications in this pilot study. CONCLUSIONS: This approach opens a generous operative exposure while safely allowing room to endoscopically maneuver and affords direct access should revision surgery be needed. SIGNIFICANCE: This procedure uses a technique familiar to otolaryngologists and may be used for pituitary and other skull base tumors. The transseptal approach to the sella turcica is the most commonly performed procedure to reach the pituitary gland. Three major variations of the transseptal approach are used: sublabial approach, external rhinoplasty approach, and transnasal approach. Each has unique advantages and disadvantages relative to each other and the endoscopic procedure, apart from the shared transseptal route ( Table 1 ). The techniques have been described elsewhere previously. 1–3 More recently, endoscopy has been used to aid the approach to the pituitary. The first endoscopic procedures used the transseptal dissection route through a standard sublabial incision, with the endoscope passed through a self-retaining speculum. 4–6 In other cases the endoscope was used for the approach only, with the binocular operating microscope subsequently used for the tumor resection. 7 Except for the wide field of vision afforded by the endoscopic approach, the morbidity of a transseptal dissection remained. More recent advances have used an endonasal approach, which allows the surgeon to bypass the transseptal dissection. 8–11 The majority of procedures performed use one nostril to pass the endoscope and other instruments, with limited endoscopic operative maneuverability. We introduce an endonasal transethmoid approach bypassing the need for a nasal retractor, headrest, and postoperative nasal packing, while providing enhanced endoscopic operative maneuverability through bimanual instrumentation using both nares and an endoscope stabilizer.
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Batta, Dr Anil, Umesh Kumar y Preeti Sharma. "Ultrasound Guided Injections in Shoulder as Compared to Direct Injections". South Asian Research Journal of Applied Medical Sciences 4, n.º 5 (30 de septiembre de 2022): 51–55. http://dx.doi.org/10.36346/sarjams.2022.v04i05.004.
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Ultrasound, also known as sonography, is an imaging method that uses high-frequency sound waves to produce real-time and dynamic images of the body. Ultrasound is increasingly being used to assist Sports Medicine Physicians, Rheumatologists, Orthopedists, and Primary Care. Procedural planning prior to any procedure increases efficiency in the operative field and reduces patient discomfort. Ultrasound is commonly utilized in regenerative medicine techniques due to the ability to visualize soft tissue targets with high resolution. Ultrasound is beneficial in both diagnostic purposes and image-guidance for procedures. Understanding how to quickly optimize the ultrasound image and ergonomics for the procedure will greatly improve your procedure workflow.
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Carriero, Serena, Gianmarco Della Pepa, Lorenzo Monfardini, Renato Vitale, Duccio Rossi, Andrea Masperi y Giovanni Mauri. "Role of Fusion Imaging in Image-Guided Thermal Ablations". Diagnostics 11, n.º 3 (19 de marzo de 2021): 549. http://dx.doi.org/10.3390/diagnostics11030549.
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Thermal ablation (TA) procedures are effective treatments for several kinds of cancers. In the recent years, several medical imaging advancements have improved the use of image-guided TA. Imaging technique plays a pivotal role in improving the ablation success, maximizing pre-procedure planning efficacy, intraprocedural targeting, post-procedure monitoring and assessing the achieved result. Fusion imaging (FI) techniques allow for information integration of different imaging modalities, improving all the ablation procedure steps. FI concedes exploitation of all imaging modalities’ strengths concurrently, eliminating or minimizing every single modality’s weaknesses. Our work aims to give an overview of FI, explain and analyze FI technical aspects and its clinical applications in ablation therapy and interventional oncology.
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Hendriks, A. A., Z. Kis, M. Glisic, W. M. Bramer y T. Szili-Torok. "Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review". Netherlands Heart Journal 28, n.º 11 (15 de septiembre de 2020): 573–83. http://dx.doi.org/10.1007/s12471-020-01485-z.
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Abstract Background Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale. Objective The aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI. Methods Eight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations. Results Of the 2990 citations reviewed for eligibility, 38 articles—enrolling a total of 7748 patients—were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74–90] in the image-guided VT ablation versus 59% [54–64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90–98] in the image-guided versus 82% [76–88] in the conventional VT ablation group (p < 0.001). Conclusions Image-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.
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Tam, Alda y Sharjeel Sabir. "Percutaneous Image-Guided Biopsy of the Spleen". Digestive Disease Interventions 02, n.º 02 (junio de 2018): 101–5. http://dx.doi.org/10.1055/s-0038-1657860.
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AbstractPercutaneous spleen biopsy has a small but important role in the diagnostic approach to splenic lesions. Nonetheless, there remain concerns about the safety of the procedure, limiting its use despite evidence that splenic biopsy performed with optimum technique has comparable diagnostic yield and safety as other solid organ biopsies. To assure appropriate use of percutaneous image-guided spleen biopsy, we discuss the rationale, technique, and outcomes of the procedure.
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Wang, Guanglei, Pengyu Wang, Yan Li, Tianqi Su, Xiuling Liu y Hongrui Wang. "A Motion Artifact Reduction Method in Cerebrovascular DSA Sequence Images". International Journal of Pattern Recognition and Artificial Intelligence 32, n.º 08 (8 de abril de 2018): 1854022. http://dx.doi.org/10.1142/s0218001418540228.
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Digital Subtraction Angiography (DSA) can be used for diagnosing the pathologies of vascular system including systemic vascular disease, coronary heart disease, arrhythmia, valvular disease and congenital heart disease. Previous studies have provided some image enhancement algorithms for DSA images. However, these studies are not suitable for automated processes in huge amounts of data. Furthermore, few algorithms solved the problems of image contrast corruption after artifact removal. In this paper, we propose a fully automatic method for cerebrovascular DSA sequence images artifact removal based on rigid registration and guided filter. The guided filtering method is applied to fuse the original DSA image and registered DSA image, the results of which preserve clear vessel boundary from the original DSA image and remove the artifacts by the registered procedure. The experimental evaluation with 40 DSA sequence images shows that the proposed method increases the contrast index by 24.1% for improving the quality of DSA images compared with other image enhancement methods, and can be implemented as a fully automatic procedure.
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Maimone, Santo, Andrey P. Morozov, Annamaria Wilhelm, Inna Robrahn, Tedra D. Whitcomb, Kathryn Y. Lin y Robert W. Maxwell. "Understanding Patient Anxiety and Pain During Initial Image-guided Breast Biopsy". Journal of Breast Imaging 2, n.º 6 (29 de septiembre de 2020): 583–89. http://dx.doi.org/10.1093/jbi/wbaa072.
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Abstract Objective Image-guided breast biopsies are safe, efficient, and reliable. However, patients are often anxious about these procedures, particularly those who have never undergone a prior biopsy. Methods This prospective IRB-approved study surveyed 163 patients undergoing their first breast biopsy. Participants provided informed consent and completed a short written survey prior to and immediately after their procedure. Level of anxiety as well as anticipated and actual levels of pain prior to and following the procedure were assessed using a 0–10-point Likert scale. Correlation, bivariate, and regression analyses were performed. Results Regarding the biopsy experience, 133/163 (81.6%) of patients reported it as better than expected. Anxiety decreased significantly from a prebiopsy mean score of 5.52 to a postbiopsy mean score of 2.25 (P < 0.001). Average and greatest pain experienced during the procedure had mean scores of 2.03 and 2.77, respectively, both significantly lower compared to preprocedural expectation (mean 4.53) (P < 0.001). Lower pain scores were reported in US-guided procedures compared to stereotactic- and MRI-guided biopsies (P < 0.001). No significant differences in pain scores were seen in those undergoing single versus multiple biopsies, or when benign, elevated-risk, or malignant lesions were sampled. Positive correlations were seen with prebiopsy anxiety levels and procedural pain as well as with anticipated pain and actual procedural pain. Conclusion Image-guided biopsies are often better tolerated by patients than anticipated. We stress the benefit of conveying this information to patients prior to biopsy, as decreased anxiety correlates with lower levels of pain experienced during the procedure.
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Cornman-Homonoff, Joshua y David Madoff. "Image-guided Biopsy of Mesenteric, Omental, and Peritoneal Disease". Digestive Disease Interventions 02, n.º 02 (junio de 2018): 106–15. http://dx.doi.org/10.1055/s-0038-1660499.
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AbstractThe peritoneum, omenta, and mesenteries can be affected by a myriad of disease processes, but many common pathologies cannot be definitively distinguished based on clinical history and imaging characteristics alone. Percutaneous image-guided biopsy is a safe, well-tolerated procedure with high diagnostic accuracy, which has supplanted more invasive means of obtaining tissue and is increasingly essential in directing patient care. An understanding of the indications, pre-procedural evaluation, technical considerations, and potential complications is essential for the radiologist who performs these procedures, and more broadly for any clinician who may request them.
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Yin, Fang-Fang, Samuel Ryu, Munther Ajlouni, Hui Yan, Jian-Yue Jin, Sung-Woo Lee, Jinkoo Kim, Jack Rock, Mark Rosenblum y Jae Ho Kim. "Image-guided procedures for intensity-modulated spinal radiosurgery". Journal of Neurosurgery 101, Supplement3 (noviembre de 2004): 419–24. http://dx.doi.org/10.3171/sup.2004.101.supplement3.0419.
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✓ Radiosurgery for brain tumors has been well established in the radiation oncology and neurosurgery fields. Radiosurgery of extracranial tumors such as those involving the spine is, however, still in the early stage because of difficulties in patient immobilization and organ motion. The authors describe an image-guided procedure for intensity-modulated spinal radiosurgery that was developed at Henry Ford Hospital.
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Zang, Xiaonan, Wennan Zhao, Jennifer Toth, Rebecca Bascom y William Higgins. "Multimodal Registration for Image-Guided EBUS Bronchoscopy". Journal of Imaging 8, n.º 7 (8 de julio de 2022): 189. http://dx.doi.org/10.3390/jimaging8070189.
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The state-of-the-art procedure for examining the lymph nodes in a lung cancer patient involves using an endobronchial ultrasound (EBUS) bronchoscope. The EBUS bronchoscope integrates two modalities into one device: (1) videobronchoscopy, which gives video images of the airway walls; and (2) convex-probe EBUS, which gives 2D fan-shaped views of extraluminal structures situated outside the airways. During the procedure, the physician first employs videobronchoscopy to navigate the device through the airways. Next, upon reaching a given node’s approximate vicinity, the physician probes the airway walls using EBUS to localize the node. Due to the fact that lymph nodes lie beyond the airways, EBUS is essential for confirming a node’s location. Unfortunately, it is well-documented that EBUS is difficult to use. In addition, while new image-guided bronchoscopy systems provide effective guidance for videobronchoscopic navigation, they offer no assistance for guiding EBUS localization. We propose a method for registering a patient’s chest CT scan to live surgical EBUS views, thereby facilitating accurate image-guided EBUS bronchoscopy. The method entails an optimization process that registers CT-based virtual EBUS views to live EBUS probe views. Results using lung cancer patient data show that the method correctly registered 28/28 (100%) lymph nodes scanned by EBUS, with a mean registration time of 3.4 s. In addition, the mean position and direction errors of registered sites were 2.2 mm and 11.8∘, respectively. In addition, sensitivity studies show the method’s robustness to parameter variations. Lastly, we demonstrate the method’s use in an image-guided system designed for guiding both phases of EBUS bronchoscopy.
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Deer, Timothy R. "New Image-Guided Ultra-Minimally Invasive Lumbar Decompression Method: The mild® Procedure". Pain Physician 1;13, n.º 1;1 (14 de enero de 2010): 35–41. http://dx.doi.org/10.36076/ppj.2010/13/35.
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Background and Objectives: Lumbar canal stenosis is a common source of chronic low back and leg pain. Minimally Invasive Lumbar Decompression (mild®) is a new minimally invasive treatment for pain relief from symptomatic central lumbar canal stenosis. The procedure involves limited percutaneous laminotomy and thinning of the ligamentum flavum in order to increase the critical diameter of the stenosed spinal canal. The objective of this technical report is to evaluate the acute safety of the mild procedure. Methods: Manual and electronic chart survey was conducted by 14 treating physicians located in 9 U.S. states on 90 consecutive patients who underwent the mild procedure. Patients within local geographical practice areas were selected in keeping with product Instructions For Use. Those patients requiring lumbar decompression via tissue resection at the perilaminar space, within the interlaminar space and at the ventral aspect of the lamina were treated. Data collected included any complications and/or adverse events occurring during or immediately following the procedure prior to discharge. Results: Of 90 procedures reviewed, there were no major adverse events or complications related to the devices or procedure. No incidents of dural puncture or tear, blood transfusion, nerve injury, epidural bleeding, or hematoma were observed. Limitations: Data were not specifically collected; however, regardless of difficulty, in this series none of the procedures were aborted and none resulted in adverse events. Efficacy parameters were not collected in this safety survey. Conclusions: This review demonstrates the acute safety of the mild procedure with no report of significant or unusual patient complications. To establish complication frequency and longer-term safety profile associated with the treatment, additional studies are currently being conducted. Survey data on file at Vertos Medical, Inc. Key words: Spine, decompression, fluoroscopy, mild, stenosis, ligamentum
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Narayanan, Sathya, Shyamkumar N. Keshava, Vinu Moses, Munawwar Ahmed, Aswin Padmanabhan y Philip Joseph. "Image Guided Percutaneous Cholecystostomy–A Single Center Experience". Journal of Clinical Interventional Radiology ISVIR 4, n.º 01 (abril de 2020): 20–26. http://dx.doi.org/10.1055/s-0040-1705263.
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Abstract Purpose To assess the technical feasibility of percutaneous cholecystostomy (PCC) for acute cholecystitis and formulate an algorithm for PCC. Materials and methods This is a retrospective study of 35 patients (28 male and 7 female; mean age 60 years) who underwent image-guided PCC from 2008 to 2018 at a tertiary care hospital in South India. Descriptive summary statistics and frequencies were used to assess the technical success and complications. Results The patients (35/35) presented with fever, abdominal pain, and a few of them had severe sepsis. All these patients were high risk for surgery considering the comorbidities (17/35) and hemodynamic instability (18/35). PCC was performed under ultrasoundguidance, through transhepatic approach, and using single puncture and modified single puncture techniques. The procedure was technically successful in all 35 patients (100%). Two patients (2/35) did not improve clinically after PCC; hence, they were taken up for emergency cholecystectomy with high-risk consent. One patient required a repeat procedure after 3 days due to tube dislodgement. There were no major procedure-related complications. Conclusion Image-guided PCC can be performed safely and is effective for treating high-risk patients with acute cholecystitis.
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Mayberg, Marc R., Eric LaPresto y Edwin J. Cunningham. "Image-guided endoscopy: description of technique and potential applications". Neurosurgical Focus 19, n.º 1 (julio de 2005): 1–5. http://dx.doi.org/10.3171/foc.2005.19.1.11.
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Object Neuroendoscopic approaches to lesions of the central nervous system and spine are limited by the loss of stereoscopic vision and high-fidelity image quality inherent in the operating microscope. Image-guided endoscopy (IGE) and image-guided surgery (IGS) have the potential to overcome these limitations. The goal of this study was to evaluate IGE for its potential applications in neurosurgery. Methods. To determine the feasibility of IGE, a rigid endoscope was tracked using an IGS system that provided navigational data for the endoscope tip and trajectory as well as a computer-generated, three-dimensional, virtual representation of the image provided by the endoscope. The IGE procedure was successfully completed in 14 patients (nine with pituitary adenomas, one with a temporal cavernous malformation, and four with unruptured aneurysms). No complications could be attributed to the procedure. Compared with direct microscopy performed using anatomical landmarks, registration of the endoscope, and virtual image were highly accurate. Conclusions This procedure offers many potential advantages for central nervous system and spinal endoscopy. Advances in IGE may enable its application to regions outside the central nervous system as well.
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Dalili, Danoob, Amanda Isaac, Ali Rashidi, Gunnar Åström y Jan Fritz. "Image-guided Sports Medicine and Musculoskeletal Tumor Interventions: A Patient-Centered Model". Seminars in Musculoskeletal Radiology 24, n.º 03 (junio de 2020): 290–309. http://dx.doi.org/10.1055/s-0040-1710065.
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AbstractThe spectrum of effective musculoskeletal (MSK) interventions is broadening and rapidly evolving. Increasing demands incite a perpetual need to optimize services and interventions by maximizing the diagnostic and therapeutic yield, reducing exposure to ionizing radiation, increasing cost efficiency, as well as identifying and promoting effective procedures to excel in patient satisfaction ratings and outcomes. MSK interventions for the treatment of oncological conditions, and conditions related to sports injury can be performed with different imaging modalities; however, there is usually one optimal image guidance modality for each procedure and individual patient. We describe our patient-centered workflow as a model of care that incorporates state-of-the-art imaging techniques, up-to-date evidence, and value-based practices with the intent of optimizing procedural success and outcomes at a patient-specific level. This model contrasts interventionalist- and imaging modality-centered practices, where procedures are performed based on local preference and selective availability of imaging modality or interventionalists. We discuss rationales, benefits, and limitations of fluoroscopy, ultrasound, computed tomography, and magnetic resonance imaging procedure guidance for a broad range of image-guided MSK interventions to diagnose and treat sports and tumor-related conditions.
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Friebe, Michael y Jörg Traub. "Image guided surgery innovation with graduate students - a new lecture format". Current Directions in Biomedical Engineering 1, n.º 1 (1 de septiembre de 2015): 475–79. http://dx.doi.org/10.1515/cdbme-2015-0114.
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AbstractIn Image Guided Surgeries (IGS), incremental innovation is normally not a technology push (technology delivered) but rather a pull (by learning and working with the clinical users) from understanding how these surgeries are performed. Engineers need to understand that only through proper observation, procedure know-how and subsequent analysis and evaluation, clinically relevant innovation can be generated. And, it is also essential to understand the associated health economics that could potentially come with new technological approaches. We created a new lecture format (6 ECTS) for graduate students that combined the basics of image guided procedures with innovation tools (Design Thinking, Lean Engineering, Value Proposition Canvas, Innovation Games) and actual visits of a surgical procedure. The students had to attend these procedures in small groups and had to identify and work on one or more innovation projects based on their observations and based on a prioritisation of medical need, pains and gains of the stakeholders, and ease of implementation. Almost 200 graduate students completed this training in the past 5 years with excellent results for the participating clinicians, and for the future engineers. This paper presents the lecture content, the setup, some statistics and results with the hope that other institutions will follow to offer similar programs that not only help the engineering students identify what clinically relevant innovation is (invention x clinical implementation), but that also pave the path for future interdisciplinary teams that will lead to incremental and disruptive innovation.
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Lasio, Giovanni, Paolo Ferroli, Giovanni Felisati y Giovanni Broggi. "Image-guided Endoscopic Transnasal Removal of Recurrent Pituitary Adenomas". Neurosurgery 51, n.º 1 (1 de julio de 2002): 132–37. http://dx.doi.org/10.1097/00006123-200207000-00020.
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Abstract OBJECTIVE To assess the role that neuronavigation plays in assisting endoscopic transsphenoidal reoperations for recurrent pituitary adenomas. METHODS During a 45-month period, 19 endoscopic endonasal transsphenoidal reoperations were performed for recurrent pituitary adenomas. In 11 of 19 patients, the procedure was performed with the aid of an optically guided system. Clinical records were reviewed retrospectively, with attention to the following: comparison of baseline clinical data, the duration of surgery, and the postoperative course and complications of both image-guided and non-image-guided endoscopic reoperations. In addition, to test the reliability of the neuronavigation system, we made measurements of intraoperative accuracy in five additional transnasal endoscopic procedures in “virgin” noses and sphenoidal sinuses. RESULTS In both groups studied, we found no difference with regard to either morbidity or mortality, which were null. The mean setup time was 13 minutes shorter in non-image-guided procedures (P = 0.021), and the operative time was 36 minutes shorter in image-guided procedures (P = 0.038). No other statistically significant differences were found between the two groups. In all cases, we found that the system performed without malfunction. Continuous information regarding instrument location and trajectory was provided to the surgeon. Measurements of the intraoperative accuracy in the axial, coronal, and sagittal planes indicated a mean intraoperatively verified system error of 1.6 ± 0.6 mm. CONCLUSION Neuronavigation can be applied during endonasal transsphenoidal endoscopic surgery and requires a minimal amount of time. It makes reoperation easier, faster, and probably safer.
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Mishra, Suraj, Danny Z. Chen y X. Sharon Hu. "Image Complexity Guided Network Compression for Biomedical Image Segmentation". ACM Journal on Emerging Technologies in Computing Systems 18, n.º 2 (30 de abril de 2022): 1–23. http://dx.doi.org/10.1145/3471190.
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Compression is a standard procedure for making convolutional neural networks (CNNs) adhere to some specific computing resource constraints. However, searching for a compressed architecture typically involves a series of time-consuming training/validation experiments to determine a good compromise between network size and performance accuracy. To address this, we propose an image complexity-guided network compression technique for biomedical image segmentation. Given any resource constraints, our framework utilizes data complexity and network architecture to quickly estimate a compressed model which does not require network training. Specifically, we map the dataset complexity to the target network accuracy degradation caused by compression. Such mapping enables us to predict the final accuracy for different network sizes, based on the computed dataset complexity. Thus, one may choose a solution that meets both the network size and segmentation accuracy requirements. Finally, the mapping is used to determine the convolutional layer-wise multiplicative factor for generating a compressed network. We conduct experiments using 5 datasets, employing 3 commonly-used CNN architectures for biomedical image segmentation as representative networks. Our proposed framework is shown to be effective for generating compressed segmentation networks, retaining up to ≈95% of the full-sized network segmentation accuracy, and at the same time, utilizing ≈32x fewer network trainable weights (average reduction) of the full-sized networks.
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Jannin, P., M. Raimbault, X. Morandi, E. Seigneuret y B. Gibaud. "Design of a neurosurgical procedure model for multimodal image-guided surgery". International Congress Series 1230 (junio de 2001): 102–6. http://dx.doi.org/10.1016/s0531-5131(01)00025-5.
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Guo, Jiayi, Chaoqun Du, Jiangshan Wang, Huijuan Huang, Pengfei Wan y Gao Huang. "Assessing a Single Image in Reference-Guided Image Synthesis". Proceedings of the AAAI Conference on Artificial Intelligence 36, n.º 1 (28 de junio de 2022): 753–61. http://dx.doi.org/10.1609/aaai.v36i1.19956.
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Assessing the performance of Generative Adversarial Networks (GANs) has been an important topic due to its practical significance. Although several evaluation metrics have been proposed, they generally assess the quality of the whole generated image distribution. For Reference-guided Image Synthesis (RIS) tasks, i.e., rendering a source image in the style of another reference image, where assessing the quality of a single generated image is crucial, these metrics are not applicable. In this paper, we propose a general learning-based framework, Reference-guided Image Synthesis Assessment (RISA) to quantitatively evaluate the quality of a single generated image. Notably, the training of RISA does not require human annotations. In specific, the training data for RISA are acquired by the intermediate models from the training procedure in RIS, and weakly annotated by the number of models' iterations, based on the positive correlation between image quality and iterations. As this annotation is too coarse as a supervision signal, we introduce two techniques: 1) a pixel-wise interpolation scheme to refine the coarse labels, and 2) multiple binary classifiers to replace a naïve regressor. In addition, an unsupervised contrastive loss is introduced to effectively capture the style similarity between a generated image and its reference image. Empirical results on various datasets demonstrate that RISA is highly consistent with human preference and transfers well across models.
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Woerdeman, Peter A., Peter W. A. Willems, Herke J. Noordmans, Cornelis A. F. Tulleken y Jan Willem Berkelbach van der Sprenkel. "Application accuracy in frameless image-guided neurosurgery: a comparison study of three patient-to-image registration methods". Journal of Neurosurgery 106, n.º 6 (junio de 2007): 1012–16. http://dx.doi.org/10.3171/jns.2007.106.6.1012.
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Object The aim of this study was to compare three patient-to-image registration methods in frameless stereotaxy in terms of their application accuracy (the accuracy with which the position of a target can be determined intraoperatively). In frameless stereotaxy, imaging information is transposed to the surgical field to show the spatial position of a localizer or surgical instrument. The mathematical relationship between the image volume and the surgical working space is calculated using a rigid body transformation algorithm, based on point-pair matching or surface matching. Methods Fifty patients who were scheduled to undergo a frameless image-guided neurosurgical procedure were included in the study. Prior to surgery, the patients underwent either computerized tomography (CT) scanning or magnetic resonance (MR) imaging with widely distributed adhesive fiducial markers on the scalp. An extra fiducial marker was placed on the head as a target, as near as possible to the intracranial lesion. Prior to each surgical procedure, an optical tracking system was used to perform three separate patient-to-image registration procedures, using anatomical landmarks, adhesive markers, or surface matching. Subsequent to each registration, the target registration error (TRE), defined as the Euclidean distance between the image space coordinates and world space coordinates of the target marker, was determined. Independent of target location or imaging modality, mean application accuracy (± standard deviation) was 2.49 ± 1.07 mm when using adhesive markers. Using the other two registration strategies, mean TREs were significantly larger (surface matching, 5.03 ± 2.30 mm; anatomical landmarks, 4.97 ± 2.29 mm; p < 0.001 for both). Conclusions The results of this study show that skin adhesive fiducial marker registration is the most accurate noninvasive registration method. When images from an earlier study are to be used and accuracy may be slightly compromised, anatomical landmarks and surface matching are equally accurate alternatives.
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Dorward, Neil L., Olaf Alberti, James D. Palmer, Neil D. Kitchen y David G. T. Thomas. "Accuracy of true frameless stereotaxy: in vivo measurement and laboratory phantom studies". Journal of Neurosurgery 90, n.º 1 (enero de 1999): 160–68. http://dx.doi.org/10.3171/jns.1999.90.1.0160.
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✓ The authors present the results of accuracy measurements, obtained in both laboratory phantom studies and an in vivo assessment, for a technique of frameless stereotaxy. An instrument holder was developed to facilitate stereotactic guidance and enable introduction of frameless methods to traditional frame-based procedures. The accuracy of frameless stereotaxy was assessed for images acquired using 0.5-tesla or 1.5-tesla magnetic resonance (MR) imaging or 2-mm axial, 3-mm axial, or 3-mm helical computerized tomography (CT) scanning. A clinical series is reported in which biopsy samples were obtained using a frameless stereotactic procedure, and the accuracy of these procedures was assessed using postoperative MR images and image fusion.The overall mean error of phantom frameless stereotaxy was found to be 1.3 mm (standard deviation [SD] 0.6 mm). The mean error for CT-directed frameless stereotaxy was 1.1 mm (SD 0.5 mm) and that for MR image—directed procedures was 1.4 mm (SD 0.7 mm). The CT-guided frameless stereotaxy was significantly more accurate than MR image—directed stereotaxy (p = 0.0001). In addition, 2-mm axial CT-guided stereotaxy was significantly more accurate than 3-mm axial CT-guided stereotaxy (p = 0.025). In the clinical series of 21 frameless stereotactically obtained biopsies, all specimens yielded the appropriate diagnosis and no complications ensued. Early postoperative MR images were obtained in 16 of these cases and displacement of the biopsy site from the intraoperative target was determined by fusion of pre- and postoperative image data sets. The mean in vivo linear error of frameless stereotactic biopsy sampling was 2.3 mm (SD 1.9 mm). The mean in vivo Euclidean error was 4.8 mm (SD 2 mm). The implications of these accuracy measurements and of error in stereotaxy are discussed.
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Woerner, Andrew, Jesse L. Wenger y Eric J. Monroe. "Single-access ultrasound-guided tunneled femoral lines in critically ill pediatric patients". Journal of Vascular Access 21, n.º 6 (15 de junio de 2020): 1034–41. http://dx.doi.org/10.1177/1129729820933527.
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Central venous access is an essential aspect of critical care for pediatric patients. In the critically ill pediatric population, image-guided procedures performed at the bedside expedite care and may reduce risks and logistical challenges associated with patient transport to a remote procedure suite such as interventional radiology. We describe our institutional technique for ultrasound-guided tunneled femoral venous access in neonates and infants and provide technical pearls from our experience, with an intended audience including specialists performing point-of-care ultrasound–guided procedures as well as interventional radiologist making their services available in the intensive care unit.
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Christou, Anna S., Amel Amalou, HooWon Lee, Jocelyne Rivera, Rui Li, Michael T. Kassin, Nicole Varble, Zion Tsz Ho Tse, Sheng Xu y Bradford J. Wood. "Image-Guided Robotics for Standardized and Automated Biopsy and Ablation". Seminars in Interventional Radiology 38, n.º 05 (24 de noviembre de 2021): 565–75. http://dx.doi.org/10.1055/s-0041-1739164.
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AbstractImage-guided robotics for biopsy and ablation aims to minimize procedure times, reduce needle manipulations, radiation, and complications, and enable treatment of larger and more complex tumors, while facilitating standardization for more uniform and improved outcomes. Robotic navigation of needles enables standardized and uniform procedures which enhance reproducibility via real-time precision feedback, while avoiding radiation exposure to the operator. Robots can be integrated with computed tomography (CT), cone beam CT, magnetic resonance imaging, and ultrasound and through various techniques, including stereotaxy, table-mounted, floor-mounted, and patient-mounted robots. The history, challenges, solutions, and questions facing the field of interventional radiology (IR) and interventional oncology are reviewed, to enable responsible clinical adoption and value definition via ergonomics, workflows, business models, and outcome data. IR-integrated robotics is ready for broader adoption. The robots are coming!
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Haque, Moududul, Sudipta Kumar Mukherjee, Mustafa Kamal y ABM Manwar Hossain. "CT Guided Stereotactic Brain Tumor Biopsy". Bangladesh Journal of Neurosurgery 9, n.º 2 (14 de enero de 2020): 86–93. http://dx.doi.org/10.3329/bjns.v9i2.44880.
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153 cases of CT guided stereotactic biopsies for intra-axial deep seated brain lesions performed by one neurosurgeon has been analyzed regarding procedure, success rate and complications. Of the 153 cases, positive tissue biopsy was found in 143 cases. In 6 patients, biopsy showed gliotic grain tissue or normal brain tissue.4 patients had complications after the procedure. Three patient developed intracerebral haemorrhage of the two died, and other died Massive MI. There was no post operative new deficits seen. CT guided Stereotactic biopsy is a very effective and low cost procedure caomparing with frameless image guided brain biopsies or open craniotomy for biopsy due to it’s higher complication rate. The detail procedure are being discussed
Bang. J Neurosurgery 2020; 9(2): 86-93
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Johnson, J. Patrick, Doniel Drazin, Wesley A. King y Terrence T. Kim. "Image-guided navigation and video-assisted thoracoscopic spine surgery: the second generation". Neurosurgical Focus 36, n.º 3 (marzo de 2014): E8. http://dx.doi.org/10.3171/2014.1.focus13532.
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Object Video-assisted thoracoscopic surgery (VATS) has evolved for treatment of a variety of spinal disorders. Early incorporation with image-guided surgery (IGS) was challenged due to reproducibility and adaptability, limiting the procedure's acceptance. In the present study, the authors report their experience with second-generation IGS and VATS technologies for anterior thoracic minimally invasive spinal (MIS) procedures. Methods The surgical procedure is described in detail including operating room set-up, patient positioning (a lateral decubitus position), placement of the spinal reference frame and portal, radiographic localization, registration, surgical instruments, and the image-guided thoracoscopic discectomy. Results Combined IGS and VATS procedures were successfully performed and assisted in anatomical localization in 14 patients. The mean patient age was 59 years (range 32–73 years). Disc herniation pathology represented the most common indication for surgery (n = 8 patients); intrathoracic spinal tumors were present in 4 patients and the remaining patients had infection and ossification of the posterior longitudinal ligament. All patients required chest tube drainage postoperatively, and all but 1 patient had drainage discontinued the following day. The only complication was a seroma that was presumed to be due to steroid therapy for postoperative weakness. At the final follow-up, 11 of the patients were improved neurologically, 2 patients had baseline neurological status, and the 1 patient with postoperative weakness was able to ambulate, albeit with an assistive device. The evolution of thoracoscopic surgical procedures occurring over 20 years is presented, including their limitations. The combination of VATS and IGS technologies is discussed including their safety and the importance of 3D imaging. In cases of large open thoracotomy procedures, surgeries require difficult, extensive, and invasive access through the chest cavity; using a MIS procedure can potentially eliminate many of the complications and morbidities associated with large open procedures. The authors report their experience with thoracic spinal surgeries that involved MIS procedures and the new technologies. Conclusions The most significant advance in IGS procedures has resulted from intraoperative CT scanning and automatic registration with the IGS workstation. Image guidance can be used in conjunction with VATS techniques for thoracic discectomy, spinal tumors, infection, and ossification of the posterior longitudinal ligament. The authors' initial experience has revealed this technique to be useful and potentially applicable to other MIS procedures.
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Singhal, Soumil y Mangerira Chinnappa Uthappa. "Role of a Checklist to Improve Patient Safety in Interventional Radiology". Journal of Clinical Interventional Radiology ISVIR 03, n.º 03 (15 de julio de 2019): 157–61. http://dx.doi.org/10.1055/s-0039-1693536.
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AbstractA checklist can be defined as a comprehensive formal list of essential actions to be taken in a specific fashion. This concept has been extended from the aviation industry to health care to improve patient outcome and patient satisfaction with a significant reduction in complication rates. This review article aims to assess the importance and benefits associated with the use of a well-formulated checklist while performing the various minimally invasive image-guided procedures. Various databases including PubMed, Medline, Scopus, and Cochrane were searched for using various keywords including “Checklist,” “Radiology,” “Interventional Radiology,” “Image-Guided Procedure,” and “minimally invasive procedure.” The use of a checklist is the way ahead especially when patients today require minimal risk but demand high-quality care. Implementation of such an easy-to-perform tailor-made mechanism can significantly improve patient outcome and patient satisfaction.
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Ramotar, H., M.-C. Jaberoo, N. K. F. Koo Ng, M. A. Pulido y H. A. Saleh. "Image-guided, endoscopic removal of migrated titanium dental implants from maxillary sinus: two cases". Journal of Laryngology & Otology 124, n.º 4 (1 de septiembre de 2009): 433–36. http://dx.doi.org/10.1017/s0022215109990958.
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AbstractObjective:We present two cases of dental implant migration into the maxillary sinus, with subsequent removal via image-guided, transnasal endoscopy.Method:Presentation of clinical cases, together with a literature review of alternative surgical techniques, the theories behind implant migration, and the benefits of an image-guided, endoscopic approach.Results:One patient was asymptomatic, and the other had begun to experience sinogenic symptoms after implant displacement. Both patients presented to the ENT clinic, and both underwent the BrainLab protocol to generate computed tomography images for navigational reconstruction. Transnasal endoscopy was carried out with this guidance, and the implants were removed successfully in both cases. Previously used surgical techniques such as the Caldwell-Luc procedure or extraction through the tooth socket have higher rates of conversion to open procedures, more damage to the nasal sinuses and higher post-operative complication rates compared with the transnasal endoscopic approach.Conclusion:Both patients underwent successful removal of their migrated dental implants with no complications, and neither required any follow-up intervention.
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Vargas-Olivares, A., O. Navarro-Hinojosa, M. Maqueo-Vicencio, L. Curiel, M. Alencastre-Miranda y J. E. Chong-Quero. "Segmentation Method for Magnetic Resonance-Guided High-Intensity Focused Ultrasound Therapy Planning". Journal of Healthcare Engineering 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/5703216.
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High-intensity focused ultrasound (HIFU) is a minimally invasive therapy modality in which ultrasound beams are concentrated at a focal region, producing a rise of temperature and selective ablation within the focal volume and leaving surrounding tissues intact. HIFU has been proposed for the safe ablation of both malignant and benign tissues and as an agent for drug delivery. Magnetic resonance imaging (MRI) has been proposed as guidance and monitoring method for the therapy. The identification of regions of interest is a crucial procedure in HIFU therapy planning. This procedure is performed in the MR images. The purpose of the present research work is to implement a time-efficient and functional segmentation scheme, based on the watershed segmentation algorithm, for the MR images used for the HIFU therapy planning. The achievement of a segmentation process with functional results is feasible, but preliminary image processing steps are required in order to define the markers for the segmentation algorithm. Moreover, the segmentation scheme is applied in parallel to an MR image data set through the use of a thread pool, achieving a near real-time execution and making a contribution to solve the time-consuming problem of the HIFU therapy planning.
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Yi, Byong Yong. "Practical Considerations in Preparing an Institutional Procedure of Image Guided Radiation Therapy". Progress in Medical Physics 24, n.º 4 (2013): 205. http://dx.doi.org/10.14316/pmp.2013.24.4.205.
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Cui, Jie, Robert Freed, Fengyong Liu y Zubin Irani. "Interrupting Rivaling Access-flow with Nonsurgical Image-guided ligation: the “IRANI” Procedure". Seminars in Dialysis 28, n.º 6 (28 de octubre de 2015): E53—E57. http://dx.doi.org/10.1111/sdi.12450.
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Fidarova, Elena F., Johannes C. A. Dimopoulos, Christian Kirisits, Daniel Berger, Jacob C. Lindegaard, Kari Tanderup y Richard Pötter. "EMBRACE Study Dummy Run: Quality Assurance Procedure for Image-Guided Cervical Brachytherapy". Brachytherapy 9 (abril de 2010): S26—S27. http://dx.doi.org/10.1016/j.brachy.2010.02.015.
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Hata, Nobuhiko, Servet Tatli, Atsushi Yamada, Olutayo Olubiyi y Stuart G. Silverman. "Nonrigid Registration of Pre-Procedural MRI and Intra-Procedural CT in CT-Guided Cryoablation of Lung Tumors to Improve Lung Tumor Conspicuity". Journal of Medical Robotics Research 01, n.º 02 (junio de 2016): 1650004. http://dx.doi.org/10.1142/s2424905x16500045.
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To improve lung tumor conspicuity during CT-guided cryoablations, we used nonrigid image registrations to fuse pre-procedural MR images and intra-procedural CT images and determined which set of CT images taken at planning, targeting, and monitoring phases of the procedure provided the most accurate and fastest registrations. In 10 percutaneous CT-guided cryoablation procedures, MR images were registered with intra-procedural CT images using a nonrigid registration technique using an intensity-based approach with affine and B-Spline transformations. The time to complete the registration as well as the accuracy of the registration defined by Target Registration Error (TRE), Dice Similarity Coefficient (DSC), and Hausdorff Distance (HD) were measured to assess the performance of the registration. The least significant difference (LSD) method was used as a post-hoc analysis for comparing time and accuracy among planning, targeting, and monitoring phases. The mean TRE of the registration ranged from 6.26 (planning) to 10.31 (monitoring) mm. The mean DSC ranged from 83.86 (monitoring) to 89.22 (planning). The mean HD values ranged from 7.74 (targeting) to 12.20 (monitoring). Mean registration time ranged from 68.67 (monitoring) to 92.02 (planning) s. Using HD, registrations in either the planning or targeting phase were more accurate than in the monitoring phase. The registration was faster using monitoring images than using planning images. Nonrigid registration techniques can be used to fuse pre-procedural MR images with intra-procedural CT images with varying performance depending on the CT images taken at the different phases of the procedure. Therefore, caution should be taken in setting expectations on accuracies and speeds of registration depending on the phases of the CT-guided ablation procedures.
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Disselhorst, Jonathan A., Marcel A. Krueger, S. M. Minhaz Ud-Dean, Ilja Bezrukov, Mohamed A. Jarboui, Christoph Trautwein, Andreas Traube et al. "Linking imaging to omics utilizing image-guided tissue extraction". Proceedings of the National Academy of Sciences 115, n.º 13 (5 de marzo de 2018): E2980—E2987. http://dx.doi.org/10.1073/pnas.1718304115.
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Phenotypic heterogeneity is commonly observed in diseased tissue, specifically in tumors. Multimodal imaging technologies can reveal tissue heterogeneity noninvasively in vivo, enabling imaging-based profiling of receptors, metabolism, morphology, or function on a macroscopic scale. In contrast, in vitro multiomics, immunohistochemistry, or histology techniques accurately characterize these heterogeneities in the cellular and subcellular scales in a more comprehensive but ex vivo manner. The complementary in vivo and ex vivo information would provide an enormous potential to better characterize a disease. However, this requires spatially accurate coregistration of these data by image-driven sampling as well as fast sample-preparation methods. Here, a unique image-guided milling machine and workflow for precise extraction of tissue samples from small laboratory animals or excised organs has been developed and evaluated. The samples can be delineated on tomographic images as volumes of interest and can be extracted with a spatial accuracy better than 0.25 mm. The samples remain cooled throughout the procedure to ensure metabolic stability, a precondition for accurate in vitro analysis.
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Rubis, A. Yu, M. A. Lebedev, Yu V. Vizilter, O. V. Vygolov y S. Yu Zheltov. "Comparative image filtering using monotonic morphological operators". Computer Optics 42, n.º 2 (24 de julio de 2018): 306–11. http://dx.doi.org/10.18287/2412-6179-2018-42-2-306-311.
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In a previous work, we proposed a Comparative Morphology (CM) construction scheme that generalized Pytyev's Morphological Image Analysis approach onto a wider range of practical image comparison applications. Within a Guided Contrasting framework, a filtering procedure and a related change detection algorithm were developed. In this work, we propose a class of CM filtering in which Mathematical Morphology operators introduced by Serra are used as smoothing operators that offer monotonically non-increasing (nondecreasing) filtering, in contrast to linear diffusion filtering and non-linear median filtering. The results of experiments on change detection based on the new CM filtering are discussed in comparison with other morphological procedures.
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Habibullah, Tarafder, Debasish Das y Deb Prasad Paul. "USG-Guided Percutaneous Aspiration: an Effective Way for Managing Appendicular Abscess". Journal of Enam Medical College 9, n.º 1 (25 de enero de 2019): 41–45. http://dx.doi.org/10.3329/jemc.v9i1.39905.
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Background: During last 2−3 decades image-guided drainage procedures have been developed complementing modern surgical drainage techniques. The development of interventional radiological procedure has made percutaneous puncture and drainage of abdominal fluid collection possible. Image-guided percutaneous drainage of appendicular abscess has become well-established because of its proven safety and efficacy.
Objectives: To evaluate the safety and feasibility of USG-guided percutaneous aspiration for draining appendicular abscess with special attention to the need for conversion and to see the nature of complications after draining of abscess.
Materials and Methods: Between May 2013 to May 2014, 25 cases of appendicular abscess were selected from the admitted patients (surgery department) in Enam Medical College & Hospital who underwent USG-guided percutaneous aspiration. Procedure was performed mostly under local anaesthesia. Patients were followed up for 6 months. Interval appendicectomy was not performed routinely.
Results: USG-guided aspiration was successful in 23 (92%) patients and in 2 (8%) patients procedure failed. Single attempt was successful in 21 (84%) cases and 4 (16%) patients needed double attempt for draining appendicular abscess. In 23 (92%) patients, PCA was done under local anaesthesia and two (8%) patients needed general anaesthesia. Complications developed in 4 (16%) patients. Four (16%) patients needed follow-up USG. Average hospital stay was 5 days (2−8 days) and average duration of using I/V antibiotic was 3.5 days (2−5 days).
Conclusion: USG-guided percutaneous aspiration is an easy and safe method for draining appendicular abscess with minimum procedural complications.
J Enam Med Col 2019; 9(1): 41-45
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Razavi, Christopher R., Paul R. Wilkening, Rui Yin, Samuel R. Barber, Russell H. Taylor, John P. Carey y Francis X. Creighton. "Image-Guided Mastoidectomy with a Cooperatively Controlled ENT Microsurgery Robot". Otolaryngology–Head and Neck Surgery 161, n.º 5 (23 de julio de 2019): 852–55. http://dx.doi.org/10.1177/0194599819861526.
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Mastoidectomy is a common surgical procedure within otology. Despite being inherently well suited for implementation of robotic assistance, there are no commercially available robotic systems that have demonstrated utility in aiding with this procedure. This article describes a robotic technique for image-guided mastoidectomy with an experimental cooperatively controlled robotic system developed for use within otolaryngology–head and neck surgery. It has the ability to facilitate enhanced operative precision with dampening of tremor in simulated surgical tasks. Its kinematic design is such that the location of the attached surgical instrument is known with a high degree of fidelity at all times. This facilitates image registration and subsequent definition of virtual fixtures, which demarcate surgical workspace boundaries and prevent motion into undesired areas. In this preliminary feasibility study, we demonstrate the clinical utility of this system to facilitate performance of a cortical mastoidectomy by a novice surgeon in 5 identical temporal bone models with a mean time of 221 ± 35 seconds.
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Bruno, Vincenzo, Mauro Badino, Francesco Riccitiello, Gianrico Spagnuolo y Massimo Amato. "Computer Guided Implantology Accuracy and Complications". Case Reports in Dentistry 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/701421.
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The computer-based method allows the computerized planning of a surgical implantology procedure, using computed tomography (CT) of the maxillary bones and prosthesis. This procedure, however, is not error-free, unless the operator has been well trained and strictly follows the protocol. A 70-year-old woman whom was edentulous asked for a lower jaw implant-supported prosthesis. A computer-guided surgery was planned with an immediate loading according to the NobelGuide technique. However, prior to surgery, new dentures were constructed to adjust the vertical dimension. An interim screwed metal-resin prosthesis was delivered just after the surgery; however, after only two weeks, it was removed because of a complication. Finally, a screwed implant bridge was delivered. The computer guided surgery is a useful procedure when based on an accurate 3D CT-based image data and an implant planning software which minimizes errors.
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Crabtree, John H. y Peter B. Hathaway. "Patient Selection and Planning for Image-Guided Peritoneal Dialysis Catheter Placement". Seminars in Interventional Radiology 39, n.º 01 (febrero de 2022): 032–39. http://dx.doi.org/10.1055/s-0041-1741078.
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AbstractImage-guided percutaneous peritoneal dialysis (PD) catheter insertion has become increasingly relied upon to provide urgent access for late presenting kidney failure patients, to overcome surgical backlogs and limited operating room access, to avoid general anesthesia in high-risk patients, and, by itself, as an alternative approach to surgical PD access. Advanced planning for the procedure is essential to assure the best possible outcome. Appropriate selection of patients for percutaneous PD catheter placement, choosing the most suitable catheter type, determining insertion and exit site locations, and final patient preparations facilitate the performance of the procedure, minimizes the risk of complications, and improves the likelihood of providing a successful long-term peritoneal access.
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Ryu, Stephen I., Steven D. Chang, Daniel H. Kim, Martin J. Murphy, Quynh-Thu Le, David P. Martin y John R. Adler. "Image-guided Hypo-fractionated Stereotactic Radiosurgery to Spinal Lesions". Neurosurgery 49, n.º 4 (1 de octubre de 2001): 838–46. http://dx.doi.org/10.1097/00006123-200110000-00011.
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Abstract OBJECTIVE This article demonstrates the technical feasibility of noninvasive treatment of unresectable spinal vascular malformations and primary and metastatic spinal tumors by use of image-guided frameless stereotactic radiosurgery. METHODS Stereotactic radiosurgery delivers a high dose of radiation to a tumor volume or vascular malformation in a limited number of fractions and minimizes the dose to adjacent normal structures. Frameless image-guided radiosurgery was developed by coupling an orthogonal pair of x-ray cameras to a dynamically manipulated robot-mounted linear accelerator that guides the therapy beam to treatment sites within the spine or spinal cord, in an outpatient setting, and without the use of frame-based fixation. The system relies on skeletal landmarks or implanted fiducial markers to locate treatment targets. Sixteen patients with spinal lesions (hemangioblastomas, vascular malformations, metastatic carcinomas, schwannomas, a meningioma, and a chordoma) were treated with total treatment doses of 1100 to 2500 cGy in one to five fractions by use of image-guided frameless radiosurgery with the CyberKnife system (Accuray, Inc., Sunnyvale, CA). Thirteen radiosurgery plans were analyzed for compliance with conventional radiation therapy. RESULTS Tests demonstrated alignment of the treatment dose with the target volume within ± 1 mm by use of spine fiducials and the CyberKnife treatment planning system. Tumor patients with at least 6 months of follow-up have demonstrated no progression of disease. Radiographic follow-up is pending for the remaining patients. To date, no patients have experienced complications as a result of the procedure. CONCLUSION This experience demonstrates the feasibility of image-guided robotic radiosurgery for previously untreatable spinal lesions.
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Fritzsche, Holger, Axel Boese y Michael Friebe. "INNOLAB- image guided surgery and therapy lab". Current Directions in Biomedical Engineering 3, n.º 2 (7 de septiembre de 2017): 235–37. http://dx.doi.org/10.1515/cdbme-2017-0049.
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AbstractIncremental innovation, something better or cheaper or more effective, is the standard innovation process for medical product development. Disruptive innovation is often not recognized as disruptive, because it very often starts as a simple and easy alternative to existing products with much reduced features and bad performance. Innovation is the invention multiplied with a commercial use, or in other words something that eventually provides a value to a clinical user or patient. To create such innovation not a technology push (technology delivered from a technical need perspective) but rather a pull (by learning and working with the clinical users) is required. Medical technology students need to understand that only through proper observation, procedure know-how and subsequent analysis and evaluation, clinically relevant and affordable innovation can be generated and possibly subsequently used for entrepreneurial ventures. The dedicated laboratory for innovation, research and entrepreneurship- INNOLAB ego.-INKUBATOR IGT (Image Guided Therapies) is financed by the state of Sachsen-Anhalt as part of the European ego.-INKUBATOR program with (EFRE funds) at the university clinic operated by the technical chair for catheter technologies and image guided surgeries. It forms a network node between medicine, research and economics. It teaches students to lead innovation processes, technology transfer to the user and is designed to stimulate the start-up intentions.
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Cheng, Kai, Lixia Li, Yanmin Du, Jiangtao Wang, Zhenghua Chen, Jian Liu, Xiangsheng Zhang, Lin Dong, Yuanyuan Shen y Zhenlin Yang. "A systematic review of image-guided, surgical robot-assisted percutaneous puncture: Challenges and benefits". Mathematical Biosciences and Engineering 20, n.º 5 (2023): 8375–99. http://dx.doi.org/10.3934/mbe.2023367.
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<abstract><p>Percutaneous puncture is a common medical procedure that involves accessing an internal organ or tissue through the skin. Image guidance and surgical robots have been increasingly used to assist with percutaneous procedures, but the challenges and benefits of these technologies have not been thoroughly explored. The aims of this systematic review are to furnish an overview of the challenges and benefits of image-guided, surgical robot-assisted percutaneous puncture and to provide evidence on this approach. We searched several electronic databases for studies on image-guided, surgical robot-assisted percutaneous punctures published between January 2018 and December 2022. The final analysis refers to 53 studies in total. The results of this review suggest that image guidance and surgical robots can improve the accuracy and precision of percutaneous procedures, decrease radiation exposure to patients and medical personnel and lower the risk of complications. However, there are many challenges related to the use of these technologies, such as the integration of the robot and operating room, immature robotic perception, and deviation of needle insertion. In conclusion, image-guided, surgical robot-assisted percutaneous puncture offers many potential benefits, but further research is needed to fully understand the challenges and optimize the utilization of these technologies in clinical practice.</p></abstract>
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Bekelis, Kimon, Tarek A. Radwan, Atman Desai y David W. Roberts. "Frameless robotically targeted stereotactic brain biopsy: feasibility, diagnostic yield, and safety". Journal of Neurosurgery 116, n.º 5 (mayo de 2012): 1002–6. http://dx.doi.org/10.3171/2012.1.jns111746.
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Object Frameless stereotactic brain biopsy has become an established procedure in many neurosurgical centers worldwide. Robotic modifications of image-guided frameless stereotaxy hold promise for making these procedures safer, more effective, and more efficient. The authors hypothesized that robotic brain biopsy is a safe, accurate procedure, with a high diagnostic yield and a safety profile comparable to other stereotactic biopsy methods. Methods This retrospective study included 41 patients undergoing frameless stereotactic brain biopsy of lesions (mean size 2.9 cm) for diagnostic purposes. All patients underwent image-guided, robotic biopsy in which the SurgiScope system was used in conjunction with scalp fiducial markers and a preoperatively selected target and trajectory. Forty-five procedures, with 50 supratentorial targets selected, were performed. Results The mean operative time was 44.6 minutes for the robotic biopsy procedures. This decreased over the second half of the study by 37%, from 54.7 to 34.5 minutes (p < 0.025). The diagnostic yield was 97.8% per procedure, with a second procedure being diagnostic in the single nondiagnostic case. Complications included one transient worsening of a preexisting deficit (2%) and another deficit that was permanent (2%). There were no infections. Conclusions Robotic biopsy involving a preselected target and trajectory is safe, accurate, efficient, and comparable to other procedures employing either frame-based stereotaxy or frameless, nonrobotic stereotaxy. It permits biopsy in all patients, including those with small target lesions. Robotic biopsy planning facilitates careful preoperative study and optimization of needle trajectory to avoid sulcal vessels, bridging veins, and ventricular penetration.
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Frighetto, Leonardo, Antonio A. F. De Salles, Eric Behnke, Zachary A. Smith y Dennis Chute. "Frameless image-guided stereotactic biopsy of parasellar lesions". Journal of Neurosurgery 98, n.º 4 (abril de 2003): 920–25. http://dx.doi.org/10.3171/jns.2003.98.4.0920.
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✓ Interactive image-guided neuronavigation was used to obtain biopsy specimens of cavernous sinus (CS) tumors via the foramen ovale. In this study the authors demonstrated a minimally invasive approach in the management of these lesions. In four patients, whose ages ranged from 29 to 89 years (mean 61.2 years) and who harbored undefined lesions invading the CS, neuronavigation was used to perform frameless stereotactic fine-needle biopsy sampling through the foramen ovale. The biopsy site was confirmed on postoperative computerized tomography scanning. The frameless technique was accurate in displaying a real-time trajectory of the biopsy needle throughout the procedure. The lesions within the CS were approached precisely and safely. Diagnostic tissue was obtained in all cases and treatment was administered with the aid of stereotactic radiosurgery or fractionated stereotactic radiotherapy. The patients were discharged after an overnight stay with no complications. Neuronavigation is a precise and useful tool for image-guided biopsy sampling of CS tumors via the foramen ovale.
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Spenkelink, Ilse M., Jan Heidkamp, Jurgen J. Fütterer y Maroeska M. Rovers. "Image-guided procedures in the hybrid operating room: A systematic scoping review". PLOS ONE 17, n.º 4 (1 de abril de 2022): e0266341. http://dx.doi.org/10.1371/journal.pone.0266341.
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Background The shift from open to minimally invasive procedures with growing complexity has increased the demand for advanced intraoperative medical technologies. The hybrid operating room (OR) combines the functionality of a standard OR with fixed advanced imaging systems to facilitate minimally invasive image-guided procedures. Objective This systematic scoping review provides an overview of the use of the hybrid OR over the years, and reports on the encountered advantages and challenges. Methods We conducted a systematic search in PubMed, Embase, Web of Science, and Cochrane library databases for studies that described procedures being performed with the aid of 3D imaging in the hybrid OR. Results The search identified 123 studies that described 44 distinct procedures, divided over nine clinical disciplines. The number of studies increased from two in 2010 to 15 in the first five months of 2020. Ninety-nine (80%) of the studies described how 3D imaging was performed in the hybrid OR; 95 (96%) used cone-beam CT; four (4%) used multi-detector CT. Advantages and challenges of the hybrid OR were described in 94 (76%) and 34 (35%) studies, respectively. The most frequently reported advantage of using a hybrid OR is the achievement of more accurate treatment results, whereas elongation of the procedure time is the most important challenge, followed by an increase in radiation dose. Conclusion In conclusion, the growing number of clinical disciplines that uses the hybrid OR shows its wide functionality. To optimize its use, future comparative studies should be conducted to investigate which procedures really benefit from being performed in the hybrid OR.
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Lee, Jiyoung, Seunghyun Jang, Jungbin Lee, Taehan Kim, Seonghan Kim, Jongbum Seo, Ki Hean Kim y Sejung Yang. "Multi-Focus Image Fusion Using Focal Area Extraction in a Large Quantity of Microscopic Images". Sensors 21, n.º 21 (5 de noviembre de 2021): 7371. http://dx.doi.org/10.3390/s21217371.
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The non-invasive examination of conjunctival goblet cells using a microscope is a novel procedure for the diagnosis of ocular surface diseases. However, it is difficult to generate an all-in-focus image due to the curvature of the eyes and the limited focal depth of the microscope. The microscope acquires multiple images with the axial translation of focus, and the image stack must be processed. Thus, we propose a multi-focus image fusion method to generate an all-in-focus image from multiple microscopic images. First, a bandpass filter is applied to the source images and the focus areas are extracted using Laplacian transformation and thresholding with a morphological operation. Next, a self-adjusting guided filter is applied for the natural connections between local focus images. A window-size-updating method is adopted in the guided filter to reduce the number of parameters. This paper presents a novel algorithm that can operate for a large quantity of images (10 or more) and obtain an all-in-focus image. To quantitatively evaluate the proposed method, two different types of evaluation metrics are used: “full-reference” and “no-reference”. The experimental results demonstrate that this algorithm is robust to noise and capable of preserving local focus information through focal area extraction. Additionally, the proposed method outperforms state-of-the-art approaches in terms of both visual effects and image quality assessments.
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Lazarus, Matthew S. "Radiation Dose and Procedure Time for 994 CT-guided Spine Pain Control Procedures". May 2017 4, n.º 20;4 (10 de mayo de 2017): E585—E591. http://dx.doi.org/10.36076/ppj.2017.e591.
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Background: Image guidance for spine pain control procedures, including epidural steroid injection, nerve root block, and facet block, can be performed with either computed tomography (CT) or conventional fluoroscopy. CT has the advantage of improved anatomic localization and use of air for contrast; however, there are concerns that CT leads to higher radiation dose and longer procedure time. Objective: To evaluate procedure time and radiation dose for multiple types of spine pain control procedures performed under CT guidance. Study Design: Retrospective evaluation. Setting: Department of radiology in single academic medical center. Methods: Institutional review board approval was obtained. We reviewed CT-guided spine procedures performed over a 12-month period from January 2012 to December 2012. Procedure type, procedure time, and dose-length product were recorded. Patient age and gender were recorded for each case; additionally, demographic and medical history data were obtained for a sub-group of patients. Results: Nine hundred ninety-four studies (performed in 699 patients) were reviewed, including 585 epidural steroid injections, 228 nerve root blocks, and 90 facet blocks. For all studies, procedure time averaged 7:34 ± 5:05, and dose-length product averaged 75 mGy·cm ± 61. Additional medical history (available for 483 patients) revealed high rate of obesity (body mass index [BMI] = 30 ± 6.8, with 76% of patients overweight [BMI > 25] and 42% obese [BMI > 30]), and frequent medical comorbidities (including hypertension [n = 179], diabetes [n = 101], renal failure [n = 30], and heart failure [n = 17]). Limitations: This study was performed retrospectively, and limited to a single institution. Conclusion: These findings add to the growing evidence that CT guidance is a safe and effective technique for epidural steroid injection. These results further demonstrate that other spine intervention procedures, including nerve root block and facet block, can also be performed under CT guidance with short procedure time and reasonable levels of radiation exposure. This approach can be effectively used in a patient population with a high rate of obesity and medical comorbidities. Key words: Epidural steroid injection, nerve root block, facet block, CT-guidance, spine intervention, radiation dose
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Moreira, Pedro, Gert van de Steeg, Thijs Krabben, Jonathan Zandman, Edsko E. G. Hekman, Ferdinand van der Heijden, Ronald Borra y Sarthak Misra. "The MIRIAM Robot: A Novel Robotic System for MR-Guided Needle Insertion in the Prostate". Journal of Medical Robotics Research 02, n.º 04 (2 de noviembre de 2017): 1750006. http://dx.doi.org/10.1142/s2424905x17500064.
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Early prostate cancer detection and treatment are of major importance to reduce mortality rate. magnetic resonance (MR) imaging provides images of the prostate where an early stage lesion can be visualized. The use of robotic systems for MR-guided interventions in the prostate allows us to improve the clinical outcomes of procedures such as biopsy and brachytherapy. This work presents a novel MR-conditional robot for prostate interventions. The minimally invasive robotics in an magnetic resonance imaging environment (MIRIAM) robot has 9 degrees-of-freedom (DoF) used to steer and fire a biopsy needle. The needle guide is positioned against the perineum by a 5 DoF parallel robot driven by piezoelectric motors. A 4 DoF needle driver inserts, rotates and fires the needle during the procedure. Piezoelectric motors are used to insert and rotate the needle, while pneumatic actuation is used to fire the needle. The MR-conditional design of the robot and the needle insertion controller are presented. MR compatibility tests using T2 imaging protocol are performed showing a SNR reduction of 25% when the robot is operational within the MR scanner. Experiments inserting a biopsy needle toward a physical target resulted in an average targeting error of 1.84[Formula: see text]mm. Our study presents a novel MR-conditional robot and demonstrated the ability to perform MR-guided needle-based interventions in soft-tissue phantoms. Moreover, the image distortion analysis indicates that no visible image deterioration is induced by the robot.
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Nunes, Thiago Franchi, Tiago Kojun Tibana, Rômulo Florêncio Tristão Santos, Bernardo Bacelar de Faria, Vinicius Adami Vayego Fornazari y Edson Marchiori. "Percutaneous access for the diagnosis of urothelial neoplasms: pictorial essay with anatomopathological correlation". Radiologia Brasileira 53, n.º 5 (octubre de 2020): 345–48. http://dx.doi.org/10.1590/0100-3984.2019.0091.
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Abstract Urothelial carcinoma is a rare malignant neoplasm, accounting for only 5% to 7% of kidney tumors and 5% of urothelial tumors. During the management of urothelial carcinoma, anatomopathological evaluation is used for stratifying the tumors into different prognostic groups to aid in the evaluation of treatment results and to optimize the management of patients. Percutaneous image-guided biopsy is a safe and feasible procedure, with high sensitivity and accuracy rates. Although image-guided percutaneous biopsy of the urinary tract is a relatively uncommon procedure, it can be considered an option in selected cases or when traditional methods, such as the ureteroscopic technique, are not possible.
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Murphy, Martin J., Steven Chang, Iris Gibbs, Quynh-Tu Le, David Martin y Daniel Kim. "Image-guided radiosurgery in the treatment of spinal metastases". Neurosurgical Focus 11, n.º 6 (diciembre de 2001): 1–7. http://dx.doi.org/10.3171/foc.2001.11.6.7.
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Object The authors describe a new method for treating metastatic spinal tumors in which noninvasive, image-guided, frameless stereotactic radiosurgery is performed. Stereotactic radiosurgery delivers a high dose of radiation in a single or limited number of fractions to a lesion while maintaining delivery of a low dose to adjacent normal structures. Methods Image-guided radiosurgery was developed by coupling an orthogonal pair of real-time x-ray cameras to a dynamically manipulated robot-mounted linear accelerator that guides the radiation beam to treatment sites associated with radiographic landmarks. This procedure can be conducted in an outpatient setting without the use of frame-based skeletal fixation. The system relies on skeletal landmarks or implanted fiducial markers to locate treatment targets. Four patients with spinal metastases underwent radiosurgery with total prescription doses of 1000 to 1600 cGy in one or two fractions. Alignment of the treatment dose with the target volume was accurate to within 1.5 mm. During the course of each treatment fraction, patient movement was less than 0.5 mm on average. Dosimetry was highly conformal, with a demonstrated ability to deliver 1600 cGy to the perimeter of an irregular target volume while keeping exposure to the cord itself below 800 cGy. Conclusions These experiences indicate that frameless radiosurgery is a viable therapeutic option for metastatic spine disease.
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Kumar, Subhash, Kranti Bhavana, Bindey Kumar, Amit Kumar Sinha y Prem Kumar. "Image Guided Sclerotherapy of Masseteric Venous Malformations". Annals of Otology, Rhinology & Laryngology 129, n.º 6 (8 de enero de 2020): 548–55. http://dx.doi.org/10.1177/0003489419898726.
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Objective: To describe results of image guided sclerotherapy of venous malformations (VM) localized in the masseter muscle. Methods: Retrospective review of prospectively maintained data was done to include consecutive cases treated over 5-year period, with minimum 6 months follow-up. Sclerotherapy was done using ultrasound (US) guided needle puncture(s) of the lesions percutaneously, and 3% polidocanol foam injected under image guidance. Results: Seventeen cases (10 male, 7 female) with mean age 15.6 years (range 6-28 years) were identified. Clinical presentation was with facial asymmetry, becoming pronounced on jaw clenching, and three cases had mild local pain. On US, the lesions appeared as partially compressible masses with anechoic spaces, showing color filling on releasing probe pressure. Fourteen had phleboliths. Eight patients had undergone magnetic resonance imaging, lesions appearing as oval, homogenous, lobulated, T2 hyperintense masses, with heterogeneous contrast enhancement. Number of sclerotherapy sessions were—single in four cases, two in eight cases and three in five cases, for total of 35 sessions (average 2.05 session per patient). The mean dose of drug injected per session was 1.85 mL and total mean dose per patient was 2.79 mL. Post-procedure vomiting occurred in one patient while all had local swelling and mild pain, lasting between 3 to 7 days. No facial nerve palsy or sloughing/ulceration/skin necrosis was noted. On US follow-up (6-26 months, mean 15.9 months), 12 patients had small echogenic masses without any vascularity, and five had small anechoic areas <25%. All patients had complete resolution of swelling and pain. Conclusions: For VMs localized to the masseter muscle, image guided sclerotherapy is highly effective and safe, and recommended as first line treatment.