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International Journal of Computer Assisted Radiology and Surgery

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01.06.2016 | Original Article

Preclinical usability study of multiple augmented reality concepts for K-wire placement

verfasst von: Marius Fischer, Bernhard Fuerst, Sing Chun Lee, Javad Fotouhi, Severine Habert, Simon Weidert, Ekkehard Euler, Greg Osgood, Nassir Navab

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 6/2016

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Abstract

Purpose

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.

Method

We design and perform a usability study to compare the performance of surgeons and their task load using three different mixed reality systems during K-wire placements. The three systems are interventional X-ray imaging, X-ray augmentation on 2D video, and 3D surface reconstruction augmented by digitally reconstructed radiographs and live tool visualization.

Results

The evaluation criteria include duration, number of X-ray images acquired, placement accuracy, and the surgical task load, which are observed during 21 clinically relevant interventions performed by surgeons on phantoms. Finally, we test for statistically significant improvements and show that the mixed reality visualization leads to a significantly improved efficiency.

Conclusion

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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Boszczyk BM, Bierschneider M, Panzer S, Panzer W, Harstall R, Schmid K, Jaksche H (2006) Fluoroscopic radiation exposure of the kyphoplasty patient. Eur Spine J 15(3):347–355CrossRefPubMedPubMedCentral

Routt ML Jr, Simonian PT, Grujic L (1995) The retrograde medullary superior public ramus screw for the treatment of anterior pelvic ring disruptions: a new technique. J Orthop Trauma 9(1):35–44CrossRefPubMed

Diotte B, Fallavollita P, Wang L, Weidert S, Thaller P-H, Euler E, Navab N (2012) Radiation-free drill guidance in interlocking of intramedullary nails. In: Ayache N, Delingette H, Golland P, Mori K (eds) Medical Image Computing and Computer-Assisted Intervention–MICCAI 2012, Springer, Berlin, Heidelberg, pp 18–25. doi:10.1007/978-3-642-33415-3_3

Friedman M (1940) A comparison of alternative tests of significance for the problem of m rankings. Ann Math Stat 11(1):86–92CrossRef

Gay SB, Sistrom C, Wang GJ, Kahler DA, Boman T, McHugh N, Goitz HT (1992) Percutaneous screw fixation of acetabular fractures with ct guidance: preliminary results of a new technique. AJR Am J Roentgenol 158(4):819–822CrossRefPubMed

Gebhard FT, Kraus MD, Schneider E, Liener UC, Kinzl L, Arand M (2006) Does computer-assisted spine surgery reduce intraoperative radiation doses? Spine 31(17):2024–2027CrossRefPubMed

Gras F, Marintschev I, Klos K, Mückley T, Hofmann GO, Kahler DM (2012) Screw placement for acetabular fractures: which navigation modality (2-dimensional vs. 3-dimensional) should be used? An experimental study. J Orthop Trauma 26(8):466–473CrossRefPubMed

Guy P, Al-Otaibi M, Harvey EJ, Helmy N (2010) The “safe zone” for extra-articular screw placement during intra-pelvic acetabular surgery. J Orthop Trauma 24(5):279–283CrossRefPubMed

Habert S, Gardiazabal J, Fallavollita P, Navab N (2015) Rgbdx: first design and experimental validation of a mirror-based rgbd x-ray imaging system. In: International symposium on Mixed and Augmented Reality (ISMAR), IEEE, Fukuoka, pp 13–18. doi:10.1109/ISMAR.2015.17

10.

Habert S, Meng M, Kehl W, Wang X, Tombari F, Fallavollita P, Navab N Augmenting mobile c-arm fluoroscopes via stereo-rgbd sensors for multimodal visualization. In: International Symposium on Mixed and Augmented Reality (ISMAR). Fukuoka, Japan (2015)

11.

Härtl R, Lam KS, Wang J, Korge A, Kandziora F, Audigé L (2013) Worldwide survey on the use of navigation in spine surgery. World Neurosurg 79(1):162–172CrossRefPubMed

12.

Hüfner T, Stübig T, Gösling T, Kendoff D, Geerling J, Krettek C (2007) Cost-benefit analysis of intraoperative 3D imaging. Der Unfallchirurg 110(1):14–21. doi:10.1007/s00113-006-1202-6

13.

Kraus M, von dem Berge S, Schöll H, Krischak G, Gebhard F (2013) Integration of fluoroscopy-based guidance in orthopaedic trauma surgery—a prospective cohort study. Injury 44(11):1486–1492CrossRefPubMed

14.

Kraus M, Weiskopf J, Dreyhaupt J, Krischak G, Gebhard F (2015) Computer-aided surgery does not increase the accuracy of dorsal pedicle screw placement in the thoracic and lumbar spine: a retrospective analysis of 2,003 pedicle screws in a level I trauma center. Global Spine J 5(2):93PubMedPubMedCentral

15.

Lee SC, Fuerst B, Fotouhi J, Fischer M, Osgood G, Navab N (2016) Calibration of RGBD camera and cone-beam CT for 3D intra-operative mixed reality visualization. Manuscript submitted for publication. Draft attached for reviewers

16.

Londei R, Esposito M, Diotte B, Weidert S, Euler E, Thaller P, Navab N, Fallavollita P (2015) Intra-operative augmented reality in distal locking. Int J Comput Assist Radiol Surg 10(9):1–9

17.

Mears DC (1999) Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg 7(2):128–141CrossRefPubMed

18.

Navab N, Blum T, Wang L, Okur A, Wendler T (2012) First deployments of augmented reality in operating rooms. Computer 7:48–55CrossRef

19.

Navab N, Heining SM, Traub J (2010) Camera augmented mobile C-arm (CAMC): calibration, accuracy study, and clinical applications. IEEE Trans Med Imaging 29(7):1412–1423CrossRefPubMed

20.

Navab N, Mitschke M, Schütz O (1999) Camera-augmented mobile c-arm (camc) application: 3d reconstruction using a low-cost mobile c-arm. In: Medical Image Computing and Computer-Assisted Intervention–MICCAI99, Springer, pp 688–697

21.

Newcombe RA, Izadi S, Hilliges O, Molyneaux D, Kim D, Davison AJ, Kohi P, Shotton J, Hodges S, Fitzgibbon A Kinectfusion (2011) Real-time dense surface mapping and tracking. In: 10th IEEE international symposium on Mixed and Augmented Reality (ISMAR), 2011, pp 127–136. doi:10.1109/ISMAR.2011.6092378

22.

Nicolau S, Lee P, Wu H, Huang M, Lukang R, Soler L, Marescaux J (2011) Fusion of C-arm X-ray image on video view to reduce radiation exposure and improve orthopedic surgery planning: first in-vivo evaluation. In: Proceedings of 15th annual conference of the international society for computer aided surgery. Computer assisted radiology and surgery

23.

Nuzzo R (2014) Statistical errors. Nature 506(7487):150–152CrossRefPubMed

24.

Pauly O, Diotte B, Fallavollita P, Weidert S, Euler E, Navab N (2015) Machine learning-based augmented reality for improved surgical scene understanding. Comput Med Imaging Graph 41:55–60

25.

Reaungamornrat S, Otake Y, Uneri A, Schafer S, Mirota D, Nithiananthan S, Stayman JW, Kleinszig G, Khanna AJ, Taylor RH, Siewerdsen J (2012) An on-board surgical tracking and video augmentation system for C-arm image guidance. Int J Comput Assist Radiol Surg 7(5):647–665CrossRefPubMed

26.

Routt MC Jr, Nork SE, Mills WJ (2000) Percutaneous fixation of pelvic ring disruptions. Clin Orthop Relat Res 375:15–29CrossRefPubMed

27.

Routt MC Jr, Simonian PT, Mills WJ (1997) Iliosacral screw fixation: early complications of the percutaneous technique. J Orthop Trauma 11(8):584–589CrossRefPubMed

28.

Schweitzer D, Zylberberg A, Córdova M, Gonzalez J (2008) Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures. Injury 39(8):869–874CrossRefPubMed

29.

Starr A, Jones A, Reinert C, Borer D (2001) Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the actabulum. Injury 32:45–50CrossRef

30.

Starr AJ, Reinert CM, Jones AL (1998) Percutaneous fixation of the columns of the acetabulum: a new technique. J Orthop Trauma 12(1):51–58CrossRefPubMed

31.

Stöckle U, Schaser K, König B (2007) Image guidance in pelvic and acetabular surgery—expectations, success and limitations. Injury 38(4):450–462. doi:10.1016/j.injury.2007.01.024

32.

Synowitz M, Kiwit J (2006) Surgeon’s radiation exposure during percutaneous vertebroplasty. J Neurosurg Spine 4(2):106–109CrossRefPubMed

33.

Traub J, Heibel TH, Dressel P, Heining SM, Graumann R, Navab N (2007) A multi-view opto-Xray imaging system. In: Medical Image Computing and Computer-Assisted Intervention–MICCAI 2007, Springer, pp 18–25

34.

Tsai RY (1987) A versatile camera calibration technique for high-accuracy 3d machine vision metrology using off-the-shelf tv cameras and lenses. IEEE J Robot Autom 3(4):323–344CrossRef

35.

Wilcoxon F (1945) Individual comparisons by ranking methods. Biometrics Bull 1(6):80–83

36.

Wilson MR, Poolton JM, Malhotra N, Ngo K, Bright E, Masters RS (2011) Development and validation of a surgical workload measure: the surgery task load index (surg-tlx). World J Surg 35(9):1961–1969CrossRefPubMedPubMedCentral

Titel: Preclinical usability study of multiple augmented reality concepts for K-wire placement
verfasst von: Marius Fischer
Bernhard Fuerst
Sing Chun Lee
Javad Fotouhi
Severine Habert
Simon Weidert
Ekkehard Euler
Greg Osgood
Nassir Navab
Publikationsdatum: 01.06.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 6/2016
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-016-1363-x

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Abstract

Purpose

Method

Results

Conclusion

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