Abstract
Background
Surgical navigation technology directed at fetoscopic procedures is relatively underdeveloped compared with other forms of endoscopy. The narrow fetoscopic field of views and the vast vascular network on the placenta make examination and photocoagulation treatment of twin-to-twin transfusion syndrome challenging. Though ultrasonography is used for intraoperative guidance, its navigational ability is not fully exploited. This work aims to integrate 3D ultrasound imaging and endoscopic vision seamlessly for placental vasculature mapping through a self-contained framework without external navigational devices.
Methods
This is achieved through development, integration, and experimentation of novel navigational modules. Firstly, a framework design that addresses the current limitations based on identified gaps is conceptualized. Secondly, integration of navigational modules including (1) ultrasound-based localization, (2) image alignment, and (3) vision-based tracking to update the scene texture map is implemented. This updated texture map is projected to an ultrasound-constructed 3D model for photorealistic texturing of the 3D scene creating a panoramic view of the moving fetoscope. In addition, a collaborative scheme for the integration of the modular workflow system is proposed to schedule updates in a systematic fashion. Finally, experiments are carried out to evaluate each modular variation and an integrated collaborative scheme of the framework.
Results
The modules and the collaborative scheme are evaluated through a series of phantom experiments with controlled trajectories for repeatability. The collaborative framework demonstrated the best accuracy (5.2 % RMS error) compared with all the three single-module variations during the experiment. Validation on an ex vivo monkey placenta shows visual continuity of the freehand fetoscopic panorama.
Conclusions
The proposed developed collaborative framework and the evaluation study of the framework variations provide analytical insights for effective integration of ultrasonography and endoscopy. This contributes to the development of navigation techniques in fetoscopic procedures and can potentially be extended to other applications in intraoperative imaging.
Similar content being viewed by others
References
Fisk NM, Duncombe GJ, Sullivan MHF (2009) The basic and clinical science of twin–twin transfusion syndrome. Placenta 30(5):379–390
Robyr R, Lewi L, Salomon LJ et al (2006) Prevalence and management of late fetal complications following successful selective laser coagulation of chorionic plate anastomoses in twin-to-twin transfusion syndrome. Am J Obstet Gynecol 194(3):796–803
Lopriore E, Oepkes D, Walther FJ (2011) Neonatal morbidity in twin–twin transfusion syndrome. Early Hum Dev 87(9):595–599
Baud D, Windrim R, Keunen J et al (2013) Fetoscopic laser therapy for twin-twin transfusion syndrome before 17 and after 26 weeks’ gestation. Am J Obstet Gynecol 208(3):197-e1
Rossi AC, D’Addario V (2008) Laser therapy and serial amnioreduction as treatment for twin-twin transfusion syndrome: a metaanalysis and review of literature. Am J Obstet Gynecol 198(2):147–152
Senat M-V, Deprest J, Boulvain M et al (2004) Endoscopic laser surgery versus serial amnioreduction for severe twin-to-twin transfusion syndrome. N Engl J Med 351(2):136–144
Hu Y, Yamanaka N, Masamune K (2014) Automatic tracking algorithm in coaxial near-infrared laser ablation endoscope for fetus surgery. Int J Optomechatron 8(3):159–178
Yamanaka N, Yamashita H, Masamune K et al (2010) An endoscope with 2 DOFs steering of coaxial Nd: YAG laser beam for fetal surgery. Trans Mechatron IEEE/ASME 15(6):898–905
Reeff M, Gerhard F, Cattin PC et al (2006) Mosaicing of endoscopic placenta images. GI Jahrestag 1(2006):467–474
Liao H, Tsuzuki M, Mochizuki T et al (2009) Fast image mapping of endoscopic image mosaics with three-dimensional ultrasound image for intrauterine fetal surgery. Minim Invasive Ther Allied Technol 18(6):332–340
Yang L, Wang J, Kobayashi E et al (2013) Ultrasound image-guided mapping of endoscopic views on a 3D placenta model: a tracker-less approach. In: Liao H, Linte CA, Masamune K, Peters TM, Zheng G (eds) Augmented reality environments for medical imaging and computer-assisted interventions, Springer, Heidelberg, pp 107–116
Yang L, Wang J, Kobayashi E et al (2015) Image mapping of untracked free-hand endoscopic views to an ultrasound image-constructed 3D placenta model. Int J Med Robot Comput Assist Surg 11(22):223–234
Yang L, Wang J, Ando T et al (2014) Vision-based endoscope tracking for 3D ultrasound image-guided surgical navigation. Comput Med Imaging Graph 40:205–216
Yang L, Wang J, Kobayashi E et al (2013) Ultrasound image-based endoscope localization for minimally invasive fetoscopic surgery. In: IEEE international conference on engineering in medicine and biology conference. IEEE, pp 1411–1413. doi:10.1109/EMBC.2013.6609774
Liao H, Tsuzuki M, Kobayashi et al E (2009) GPU-based fast 3D ultrasound-endoscope image fusion for complex-shaped objects. In: World Congress on Medical Physics and Biomedical Engineering. Springer, Berlin Heidelberg, pp 206–209. doi:10.1007/978-3-642-03904-1_58
Cleary K, Peters TM (2010) Image-guided interventions: technology review and clinical applications. Annu Rev Biomed Eng 12:119–142
Peters T, Cleary K (2008) Image-guided interventions: technology and applications. Springer, New York
Elfring R, de la Fuente M, Radermacher K (2010) Assessment of optical localizer accuracy for computer aided surgery systems. Comput Aided Surg 15(1–3):1–12
Harada K, Miwa M, Fukuyo T et al (2009) ICG fluorescence endoscope for visualization of the placental vascular network: ORIGINAL ARTICLE. Minim Invasive Ther Allied Technol 18(1):3–7
Ishiyama A, Kim K, Yamashita H et al (2011) New fluorescence endoscope for use in twin–twin transfusion syndrome: in vivo visualization of placental blood vessels. Med Eng Phys 33(3):381–385
Kim K, Kubota M, Ohkawa Y et al (2011) A novel ultralow-illumination endoscope system. Surg Endosc 25(6):2029–2033
Kubota A, Yang L, Wang J et al (2014) Contrast enhancement between vasculature and placenta using narrow band images for TTTS surgery. Int J Comput Assist Radiol Surg 9(Suppl 1):S98–S99
Bay H, Tuytelaars T, Van Gool L (2006) Surf: Speeded up robust features. Computer vision—ECCV 2006, Springer, pp 404–417
Fryer JG, Brown DC (1986) Lens distortion for close-range photogrammetry. Photogramm Eng Remote Sen 52(1):51–58
Lepetit V, Moreno-Noguer F, Fua P (2009) Epnp: an accurate o (n) solution to the pnp problem. Int J Comput Vis 81(2):155–166
Kobayashi E, Ando T, Yamashita H et al (2009) A high-resolution, three-dimensional thin endoscope for fetal surgery. Surg Endosc 23(11):2450–2453
Mashiach R, Mezhybovsky V, Nevler A et al (2014) Three-dimensional imaging improves surgical skill performance in a laparoscopic test model for both experienced and novice laparoscopic surgeons. Surg Endosc 28(12):3489–3493
Acknowledgments
This work was supported by JSPS KAKENHI Grant Number 26108008, JSPS KAKENHI Grant number 20345268, and Grant for Translational Systems Biology and Medicine Initiative (TSBMI) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosures
Dr. Ichiro Sakuma receives grants from the Japan Science and Technology Agency. Dr. Toshio Chiba and Dr. Etsuko Kobayashi receive grants from the Japan Society for the Promotion of Science. Dr. Liangjing Yang, Dr. Junchen Wang, Dr. Takehiro Ando, Dr. Hiromasa Yamashita, and Mr. Akihiro Kubota have no conflicts of interest or financial ties to disclose.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Video 1: 3D Placental Vasculature Image Mapping
Video 2: Ultrasound-Based Image Mapping
Video 3: Vision-Based Image Mapping
Video 4: 3D Placental Vasculature Image Mapping on Monkey Placenta
Rights and permissions
About this article
Cite this article
Yang, L., Wang, J., Ando, T. et al. Self-contained image mapping of placental vasculature in 3D ultrasound-guided fetoscopy. Surg Endosc 30, 4136–4149 (2016). https://doi.org/10.1007/s00464-015-4690-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-015-4690-z