Registration using 3D-printed rigid templates outperforms manually scanned surface matching in image-guided temporal bone surgery
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Image-guided surgery (IGS) for otological procedures requires minimal invasiveness and a high degree of accuracy. We have recently developed a noninvasive registration method, the Surface Template-Assisted Marker Positioning (STAMP) method, which uses a rigid template of the surface of the temporal bone. However, the STAMP method is not applicable when the bony surface is not exposed, such as in endoscopic surgery. Thus, we extended our research to apply the STAMP method onto the skin and tested its feasibility in this study.
We designed a phantom made of a rigid box and soft material for the study. The target registration error (TRE) was measured at preset measuring points in the phantom. We modified the STAMP method to be applicable for use on the skin around the ears (S-STAMP). The same phantom was also registered using the conventional, manually scanned surface matching method. We compared the TRE after the different registration methods.
The TRE after the S-STAMP registration method was significantly smaller than that of the conventional surface matching method at all error measurement points in the phantom. However, the TRE after the S-STAMP registration method was significantly larger than that of paired point registration using invasive fiducial markers.
The S-STAMP method using a rigid template on the soft surface yields a significantly smaller TRE than that of conventional, manually scanned surface matching registration. This strategy provides an alternative option to improve the accuracy of IGS without loading patients with additional invasive procedures.
KeywordsImage-guided surgery Otology Surgical navigation Registration Transcanal endoscopic ear surgery
The authors thank Dr. Kazuo Tanoue and Mr. Yoshitsugu Suzuki at Ueno Hospital, Fukuoka, Japan, for helping us obtain the CT dataset of the phantom. A part of this study was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 26108010 (to M.H).
Compliance with ethical standards
Conflict of interest
M.Y., B.C., N.K., S.O., J.L., J.B., T.A., and M.H.: None. N.M. is an applicant of patents related to the STAMP method, and thus, he declares this fact as a potential conflict of interest.
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