Laboratory test of Single Landmark registration method for ultrasound-based navigation in laparoscopy using an open-source platform

Javier Pérez De Frutos,Erlend F Hofstad,Ronald Mårvik,Thomas Langø,Ole Vegard Solberg,Frank Lindseth,Ole Jakob Elle,Geir Arne Tangen

doi:10.1007/s11548-018-1830-7

Javier Pérez De Frutos, Erlend F Hofstad + Show 6 more

Open Access

https://doi.org/10.1007/s11548-018-1830-7

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Abstract

PurposeTest the feasibility of the novel Single Landmark image-to-patient registration method for use in the operating room for future clinical trials. The algorithm is implemented in the open-source platform CustusX, a computer-aided intervention research platform dedicated to intraoperative navigation and ultrasound, with an interface for laparoscopic ultrasound probes.MethodsThe Single Landmark method is compared to fiducial landmark on an IOUSFAN (Kyoto Kagaku Co., Ltd., Japan) soft tissue abdominal phantom and T2 magnetic resonance scans of it.ResultsThe experiments show that the accuracy of the Single Landmark registration is good close to the registered point, increasing with the distance from this point (12.4 mm error at 60 mm away from the registered point). In this point, the registration accuracy is mainly dominated by the accuracy of the user when clicking on the ultrasound image. In the presented set-up, the time required to perform the Single Landmark registration is 40% less than for the FLRM.ConclusionThe Single Landmark registration is suitable for being integrated in a laparoscopic workflow. The statistical analysis shows robustness against translational displacements of the patient and improvements in terms of time. The proposed method allows the clinician to accurately register lesions intraoperatively by clicking on these in the ultrasound image provided by the ultrasound transducer. The Single Landmark registration method can be further combined with other more accurate registration approaches improving the registration at relevant points defined by the clinicians.

Highlights

Introduction and backgroundWith the improvements in minimally invasive surgery techniques and instruments in recent years, there is a trend towards more use of the laparoscopic approach, open surgery remains the gold standard for abdominal surgeries
A total of 60 target registration error (TRE) [23] samples were computed for each registration method
This study introduces the novel Single Landmark registration method (SLRM) using an open-source platform for US-based navigation in laparoscopy

Summary

Introduction

With the improvements in minimally invasive surgery techniques and instruments in recent years, there is a trend towards more use of the laparoscopic approach, open surgery remains the gold standard for abdominal surgeries. To overcome the reduced field of view, the surgeons make use of a laparoscopic video camera for instrument guidance and other image modalities like ultrasound (US) for inspection and assessment of the lesion. Laparoscopic ultrasound (LUS) was introduced originally by Yamakawa and co-workers in 1958 [5], providing realtime information of the inside of the organs. Jakimowicz and Reuers introduced LUS scanning for examination of the biliary tree during laparoscopic cholecystectomy in 1991 [6]. The use of LUS has expanded with the increase in minimally invasive procedures. LUS is applied in a large number of procedures, such as screening for lymph nodes identification and tumour scanning; diagnostic detec-

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