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A Clinical Pilot Study of a Modular Video-CT Augmentation System for Image-Guided Skull Base Surgery.

Wen P Liu1, Daniel J Mirota1, Ali Uneri1

  • 1Department of Computer Science, Johns Hopkins University, Baltimore MD.

Proceedings of Spie--The International Society for Optical Engineering
|July 21, 2023
PubMed
Summary

This study introduces a video augmentation system for endoscopic skull base surgery, enhancing visualization of critical structures using preoperative imaging data. The system aims to improve surgical navigation and confidence during complex procedures.

Keywords:
image-guided surgeryskull-base surgerysurgical navigationvideo endoscopyvideo-CT augmentation

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Computer-Assisted Surgery

Background:

  • Endoscopic skull base surgery faces challenges in visualizing critical neurovascular structures.
  • Augmenting endoscopic video with preoperative imaging can enhance surgical performance.

Purpose of the Study:

  • To engineer and evaluate a practical video augmentation system for endoscopic skull base surgery.
  • To assess the feasibility and benefits of overlaying computed tomography (CT) or magnetic resonance (MR) planning data in real-time endoscopic video.

Main Methods:

  • Developed a modular video augmentation system with automated camera calibration.
  • Achieved high accuracy in camera calibration (0.7±0.3 pixels re-projection error, 2.3±1.5 mm target registration error).
  • Conducting an IRB-approved clinical pilot study with 15 patients undergoing skull base tumor surgery, comparing augmented vs. standard video displays.

Main Results:

  • The system demonstrated high accuracy in camera calibration, crucial for precise image overlay.
  • A clinical pilot study is underway to evaluate the system's impact on surgical confidence and performance.
  • Surgeon questionnaires are used to assess the benefits of real-time video augmentation.

Conclusions:

  • The developed video augmentation system shows promise for improving surgical navigation and safety in endoscopic skull base procedures.
  • The modular design allows for potential application in other endoscopic surgeries.
  • Ongoing clinical evaluation will determine the system's definitive impact on surgical outcomes.