Abstract
PurposeIn current clinical practice, intraoperative repositioning of mobile C-arms is challenging due to a lack of visual cues and efficient guiding tools. This can be detrimental to the surgical workflow and lead to additional radiation burdens for both patient and personnel. To overcome this problem, we present our novel approach Lidar-based X-ray Positioning for Mobile C-arms (RAY-POS) for assisting circulating nurses during intraoperative C-arm repositioning without requiring external aids.MethodsRAY-POS consists of a localization module and a graphical user interface for guiding the user back to a previously recorded C-Arm position. We conducted a systematic comparison of simultaneous localization and mapping (SLAM) algorithms using different attachment positions of light detection and ranging (LIDAR) sensors to benchmark localization performance within the operating room (OR). For two promising combinations, we conducted further end-to-end repositioning tests within a realistic OR setup.ResultsSLAM algorithm gmapping with a LIDAR sensor mounted 40 cm above the C-arm’s horizontal unit performed best regarding localization accuracy and long-term stability. The distribution of the repositioning error yielded an effective standard deviation of 7.61 mm.ConclusionWe conclude that a proof-of-concept for LIDAR-based C-arm repositioning without external aids has been achieved. In future work, we mainly aim at extending the capabilities of our system and evaluating the usability together with clinicians.
Highlights
PurposeMobile C-arms are an established and widely used means for intraoperative imaging
Such algorithms use different sensor modalities—in our case 2D light detection and ranging (LIDAR) sensors and an inertial measurement unit (IMU)—to construct a map of the environment and, at the same time, calculate the current pose within the map. 2D LIDAR sensors measure the distance to surrounding obstacles by rotating a pulsed laser beam and detecting the reflected light in an adjustable number of directions within the measurement plane
Average results for data sets representing short trajectories without disturbances are given in Table 1 (10 data sets for each combination of LIDAR position and simultaneous localization and mapping (SLAM) algorithm)
Summary
Mobile C-arms are an established and widely used means for intraoperative imaging Due to their maneuverability and International Journal of Computer Assisted Radiology and Surgery cues, which would have supported realignment of the C-arm, may not be present anymore. This may be due to the installment of tools or coverings, or due to blood leakage caused by surgical manipulations. The heavy C-arm needs to be maneuvered repeatedly, which is physically demanding and ergonomically critical, especially for translational corrections. This method increases radiation exposure of the patient and the surgical team alike, without providing any therapeutic benefit. The surgical workflow may be delayed considerably by such a trial-and-error approach [3], effectively increasing the stress load of the staff as well as overall costs of the intervention
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