Purpose

Interactive image-guided surgery technologies enable accurate target localization while preserving critical nearby structures in many surgical interventions. Current state-of-the-art interfaces largely employ traditional anatomical cross-sectional views or augmented reality environments to present the actual spatial location of the surgical instrument in preoperatively acquired images. This work proposes an alternative, simple, minimalistic visual interface intended to assist during real-time surgical target localization.

Methods

The estimated 3D pose of the interventional instruments and their positional uncertainty are intuitively presented in a visual interface with respect to the target point. A usability study with multidisciplinary participants evaluates the proposed interface projected in surgical microscope oculars against cross-sectional views. The latter was presented on a screen both stand-alone and combined with the proposed interface. The instruments were electromagnetically navigated in phantoms.

Results

The usability study demonstrated that the participants were able to detect invisible targets marked in phantom imagery with significant enhancements for localization accuracy and duration time. Clinically experienced users reached the targets with shorter trajectories. The stand-alone and multi-modal versions of the proposed interface outperformed cross-sectional views-only navigation in both quantitative and qualitative evaluations.

Conclusion

The results and participants’ feedback indicate potential to accurately navigate users toward the target with less distraction and workload. An ongoing study evaluates the proposed system in a preclinical setting for auditory brainstem implantation.

中文翻译：

---

手术靶向的视觉显示：概念和可用性研究

目的

交互式图像引导手术技术可实现准确的目标定位，同时在许多手术干预中保留关键的附近结构。当前最先进的界面主要采用传统的解剖横截面视图或增强现实环境，以在术前采集的图像中呈现手术器械的实际空间位置。这项工作提出了一种替代的、简单的、简约的视觉界面，旨在帮助实时手术目标定位。

方法

介入器械的估计 3D 姿态及其位置不确定性以相对于目标点的可视化界面直观呈现。一项多学科参与者的可用性研究评估了投影在手术显微镜目镜中的拟议界面与横截面视图。后者显示在单独的屏幕上，并与建议的界面相结合。这些仪器在幻影中进行电磁导航。

结果

可用性研究表明，参与者能够检测到标记在幻影图像中的隐形目标，并显着提高了定位精度和持续时间。有临床经验的用户以更短的轨迹达到目标。所提出的界面的独立和多模式版本在定量和定性评估中都优于仅横截面视图的导航。

结论

结果和参与者的反馈表明有可能以更少的分心和工作量来准确地将用户导航到目标。一项正在进行的研究在听觉脑干植入的临床前环境中评估了拟议的系统。