Chapter 4 - Image-Guided Surgery Through Internet of Things

Abstract

The Internet of Things (IoT) is a network of devices connected to each other via the Internet, which makes the devices “smart.” Today, the IoT plays a very important role in healthcare to improve the quality of the healthcare system. Various diseases require surgery for treatment. Image-guided surgery (IGS) is a surgical process in which surgeons use an invasive tracked instrument to make a preoperative image that helps in treatment of specific diseases. IGS helps the surgeons obtain better results during the surgical process. For a demanding surgery, the main steps are: obtaining different images of the target area at different times and angles, planning, intraprocess guidance, positioning of the surgical device, and any postoperative processes. The components of IGS are a workstation, navigation tool, patient’s images dataset and all these are connected through the Internet. The success of the surgery is based on the direct visualization of the target area and the tracking tool. Before surgical treatment, for planning the different images of the target area are taken by suitable imaging modalities such as magnetic resonance imaging, computed tomography, ultrasound, and positron emission tomography. The choice of imaging modalities depends on the target area and disease. The distinct images of the same area acquired in different periods need to be aligned into one image, as the information of a single image is not sufficient for the situation of the target area inside the body; this process provides a more informative image that helps the surgeons. The process of aligning images into a single image is known as image registration. Registration methods may be based on intensity, features, or fluoroscopy. The second most important component of the IGS system is the tracking tool, a tool that shows the real-time position and situation of the medical device throughout the surgical process. In IGS, various tracking tools are present: optical, mechanical position pointer, and electromagnetic tracking tool. IGS is used in medicine for the treatment of various diseases in which only surgery is required, such as tumor resection, dental implant, liver biopsy, spinal surgery, and orthopedic surgery. IGS has merits and demerits. Direct visualization, higher surgery success rate, and greater surgical confidence are the advantages, whereas heavy and costly equipment, set-up time, and training are some disadvantages of this system. IGS software is available, including the Image-Guided Surgery Toolkit (IGSTK), 3D Slicer, Medical Imaging Interaction Toolkit (MITK), and VERSION.