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Proceedings Paper

The use of virtual fiducials in image-guided kidney surgery
Author(s): Courtenay Glisson; Rowena Ong; Amber Simpson; Peter Clark; S. Duke Herrell; Robert Galloway
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Paper Abstract

The alignment of image-space to physical-space lies at the heart of all image-guided procedures. In intracranial surgery, point-based registrations can be used with either skin-affixed or bone-implanted extrinsic objects called fiducial markers. The advantages of point-based registration techniques are that they are robust, fast, and have a well developed mathematical foundation for the assessment of registration quality. In abdominal image-guided procedures such techniques have not been successful. It is difficult to accurately locate sufficient homologous intrinsic points in imagespace and physical-space, and the implantation of extrinsic fiducial markers would constitute "surgery before the surgery." Image-space to physical-space registration for abdominal organs has therefore been dominated by surfacebased registration techniques which are iterative, prone to local minima, sensitive to initial pose, and sensitive to percentage coverage of the physical surface. In our work in image-guided kidney surgery we have developed a composite approach using "virtual fiducials." In an open kidney surgery, the perirenal fat is removed and the surface of the kidney is dotted using a surgical marker. A laser range scanner (LRS) is used to obtain a surface representation and matching high definition photograph. A surface to surface registration is performed using a modified iterative closest point (ICP) algorithm. The dots are extracted from the high definition image and assigned the three dimensional values from the LRS pixels over which they lie. As the surgery proceeds, we can then use point-based registrations to re-register the spaces and track deformations due to vascular clamping and surgical tractions.

Paper Details

Date Published: 2 March 2011
PDF: 9 pages
Proc. SPIE 7964, Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling, 796402 (2 March 2011); doi: 10.1117/12.877092
Show Author Affiliations
Courtenay Glisson, Vanderbilt Univ. (United States)
Rowena Ong, Vanderbilt Univ. (United States)
Amber Simpson, Vanderbilt Univ. (United States)
Peter Clark, Vanderbilt Univ. (United States)
S. Duke Herrell, Vanderbilt Univ. (United States)
Robert Galloway, Vanderbilt Univ. (United States)


Published in SPIE Proceedings Vol. 7964:
Medical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling
Kenneth H. Wong; David R. Holmes, Editor(s)

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