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Updated: May 31, 2026
05:37
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
TREK: an integrated system architecture for intraoperative cone-beam CT-guided surgery
A Uneri1, S Schafer, D J Mirota
1Department of Computer Science, Johns Hopkins University, Baltimore, MD 21205-2109, USA. ali.uneri@jhu.edu
Summary
A new system architecture, TREK, integrates intraoperative 3D imaging like cone-beam CT (CBCT) with surgical navigation tools. This modular system streamlines data integration for diverse surgical needs, enhancing precision in image-guided interventions.
Area of Science:
- Medical Imaging
- Computer-Assisted Surgery
- Surgical Navigation Systems
Background:
- Image-guided surgery relies on integrating various data sources for enhanced visualization and precision.
- Intraoperative 3D imaging, such as mobile C-arm cone-beam CT (CBCT), offers valuable real-time anatomical information.
- Existing systems often face challenges in seamlessly integrating diverse data streams and adapting to specific surgical workflows.
Purpose of the Study:
- To develop and describe a novel system architecture for integrating intraoperative 3D imaging (CBCT) with surgical navigation.
- To create a modular framework capable of handling diverse data sources for application-specific surgical scenarios.
- To streamline the use of CBCT guidance in image-guided interventions through modular tool development.
Main Methods:
- The architecture leverages open-source software (cisst and 3D Slicer) and Python scripting for modular integration.
- It combines preoperative data, surgical navigation tools (trackers, endoscopy), and intraoperative CBCT data.
- A modular, object-oriented approach simplifies device integration and minimizes offline data processing, focusing on online geometric precision analysis.
Main Results:
- The TREK architecture successfully integrates intraoperative CBCT with multiple data sources for surgical navigation.
- Developed modules facilitate multi-modality image display, 3D-3D and 3D-2D registration, and hybrid tracker utilization.
- Demonstrated utility in preclinical temporal bone, skull base, and spine surgeries, showcasing adaptability to complex requirements.
Conclusions:
- A modular system architecture (TREK) has been designed for image-guided surgery, enhancing intraoperative CBCT utilization.
- The system effectively integrates diverse data sources, streamlining tool interfaces and accommodating varied surgical workflows.
- The architecture accelerates the testing and clinical translation of novel surgical tools from a common codebase.
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