Augmenting intraoperative ultrasound with preoperative magnetic resonance planning models for percutaneous renal access
Ultrasound (US) is a commonly-used intraoperative imaging modality for guiding percutaneous renal access (PRA). However, the anatomy identification and target localization abilities of the US imaging are limited. This paper evaluates the feasibility and efficiency of a proposed image-guided PRA by augmenting the intraoperative US with preoperative magnetic resonance (MR) planning models.
First, a preoperative surgical planning approach is presented to define an optimal needle trajectory using MR volume data. Then, a MR to US registration is proposed to transfer the preoperative planning into the intraoperative context. The proposed registration makes use of orthogonal US slices to avoid local minima while reduce processing time. During the registration, a respiratory gating method is used to minimize the impact of kidney deformation. By augmenting the intraoperative US with preoperative MR models and a virtual needle, a visual guidance is provided to guarantee the correct execution of the surgical planning. The accuracy, robustness and processing time of the proposed registration were evaluated by four urologists on human data from four volunteers. Furthermore, the PRA experiments were performed by the same four urologists on a kidney phantom. The puncture accuracy in terms of the needle-target distance was measured, while the perceptual quality in using the proposed image guidance was evaluated according to custom scoring method.
The mean registration accuracy in terms of the root mean square (RMS) target registration error (TRE) is 3.53 mm. The RMS distance from the registered feature points to their average is 0.81 mm. The mean operating time of the registration is 6'4". In the phantom evaluation, the mean needle-target distance is 2.08 mm for the left lesion and 1.85 mm for the right one. The mean duration for all phantom PRA tests was 4'26". According to the custom scoring method, the mean scores of the Intervention Improvement, Workflow Impact, and Clinical Relevance were 4.0, 3.3 and 3.9 respectively.
The presented image guidance is feasible and promising for PRA procedure. With careful setup it can be efficient for overcoming the limitation of current US-guided PRA.
- Troccaz J, Baumann M, Berkelman P, et al.: Medical image computing and computer-aided medical interventions applied to soft tissues: work in progress in urology. Proc IEEE 2006,94(9):1665–1677. CrossRef
- Ukimura O: Image-guided surgery in minimally invasive urology. Curr Opin Urol 2010, 20:136–140. CrossRef
- Kalogeropoulou C, Kallidonis P, Liatsikos EN: Imaging in percutaneous nephrolithotomy. J Endourol 2009,23(10):1571–1577. CrossRef
- Hosseini MM, Hassanpour A, Farzan R, Yousefi A, Afrasiabi MA: Ultrasonography-guided percutaneous Nephrolithotomy. J Endourol 2009,23(4):603–607. CrossRef
- Lee JY, Choi BI, Chung YE, Kim MW, Kim SH, Han JK: Clinical value of CT/MR-US fusion imaging for radiofrequency ablation of hepatic nodules. Eur J Radiol 2011. available online
- Baumhauer M, Feuerstein M, Meinzer H-P, Rassweiler J: Navigation in endoscopic soft tissue surgery: perspectives and limitations. J Endourol 2008,22(4):751–766. CrossRef
- Sandhu C, Anson KM, Patel U: Urinary tract stones-Part I: role of radiological imaging in diagnosis and treatment planning. Clin Radiol 2003, 58:415–421. CrossRef
- Jung EM, Friedrich C, Hoffstetter P, Dendl LM, Klebl F, Agha A, Wiggermann P, Stroszcynski C, Schreyer AG: Volume navigation with contrast enhanced ultrasound and image fusion for percutaneous interventions: first results. PLoS One 2012,7(3):e33956. CrossRef
- Hakime A, Deschamps F, Carvalho EGMD, Teriitehau C, Auperin A, Baere TD: Clinical evaluation of spatial accuracy of a fusion imaging technique combining previously acquired CT and real-time US for imaging of liver metastases. Cardiovasc Intervent Radiol 2011, 34:338–344. CrossRef
- Leroy A, Mozer P, Payan Y, Troccaz P: Rigid registration of freehand 3D ultrasound and CT-scan kidney images. Proc Int Conf (MICCAI) 2004, 3216:837–844.
- Penny GP, Blackall JM, Hamady MS, Sabharwal T, Adam A, Hawks DJ: Registration of freehand 3D ultrasound and magnetic resonance liver images. Med Image Anal 2004,8(1):81–91. CrossRef
- Deshpande VS, Shea SM, Laub G, Simonetti OP, Finn JP, Li D: 3D magnetization-prepared True-FISP: A new technique of the MR imaging of coronary arteries. Magn Reson Med 2001,46(3):494–502. CrossRef
- Lesage D, Angelini ED, Bloch I, Funka-Lea G: A review of 3D vessel lumen segmentation techniques: models, features and extraction schemes. Med Image Anal 2009, 13:819–845. CrossRef
- Lorensen WE, Cline HE: Marching cubes: a high resolution 3D surface construction algorithm. ACM Siggraph Computer Graphics 1987, 21:163–169. CrossRef
- Brandner ED, Wu A, Chen H, Heron D, Kalnicki S, Komanduri K, Gerszten K, Burton S, Ahmed I, Shou Z: Abdominal organ motion measured using 4D CT. Int J Radiat Oncol Biol Phys 2006,65(2):554–560. CrossRef
- Balter JM, Lam KL, McGinn CJ, Lawrence TS, Haken RKT: Improvement of CT-based treatment-planning models of abdominal targets using static exhale imaging. Int J Radiat Oncol Biol Phys 1998,41(4):939–943. CrossRef
- Penney GP, Blackall JM, Hayashi D, Sabharwal T, Adam A, Hawkes DJ: Overview of an ultrasound to CT or MR registration system for use in thermal ablation of liver metastases. Proc Med Image Underst Anal 2001.
- Besl PJ, McKay ND: A method for registration of 3-D shapes. IEEE Trans Patt Anal and Mach Intell 1992,14(2):239–256. CrossRef
- Dryden IL, Mardia KV: Statistical shape analysis. New York: Wiley; 1998.
- Jannin P, Fitzpatrick JM, Hawkes DJ, Pennec X, Shahidi R, Vanniew MW: Validation of medical image processing in image-guided therapy. IEEE Trans Med Imag 2002,21(12):1445–1449. CrossRef
- Mozer P, Leroy A, Payan Y, Troccaz J, Chartier-Kastler E, Richard F: Computer-assisted access to the kidney. Int J Med Robot Comp 2005,1(4):58–66. CrossRef
- John BS, Rowland D, Ratnam L, Walkden M, Nayak S, Patel U, Anson K, Nassiri D: Percutaneous renal intervention: comparison of 2-D and time-resolved 3-D (4-D) ultrasound for minimal calyceal dilation using an ultrasound phantom and fluoroscopic control. Ultrasound Med Biol 2008,34(11):1765–1769. CrossRef
- Ghani KR, Pilcher J, Patel U, Rowland D, Nassiri D, Anson K: Three-dimensional ultrasound reconstruction of the pelvicaliceal system: an in-vitro study. World J Urol 2008,26(5):493–498. CrossRef
- Rowland D, Patel U, Pilcher J, Anson K, Nassiri D: Evaluation of the accuracy of 3-dimensional ultrasonography of the kidney using an in vitro renal model. J Ultrasound Med 2009,28(2):155–162.
- Ghani KR, Patel U, Anson K: Computed tomography for percutaneous renal access. J Endourol 2009,23(10):1633–1639. CrossRef
- Silverman SG, Leyendecker JR, Amis ES Jr: What is the current role of CT urography and MR urography in the evaluation of the urinary tract? Radiology 2009,250(2):309–323. CrossRef
- Augmenting intraoperative ultrasound with preoperative magnetic resonance planning models for percutaneous renal access
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- Available under Open Access This content is freely available online to anyone, anywhere at any time.
BioMedical Engineering OnLine
- Online Date
- August 2012
- Online ISSN
- BioMed Central
- Additional Links
- Author Affiliations
- 1. Shenzhen Key Laboratory for Low-cost Healthcare, Key Lab for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Xueyuan Avenue 1068, Shenzhen, 518055, China
- 2. Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
- 3. Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China