R H Taylor

Publications (8)5.92 Total impact

• Article: An on-board surgical tracking and video augmentation system for C-arm image guidance.

  S Reaungamornrat, Y Otake, A Uneri, S Schafer, D J Mirota, S Nithiananthan, J W Stayman, G Kleinszig, A J Khanna, R H Taylor, J H Siewerdsen
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  ABSTRACT: Conventional tracker configurations for surgical navigation carry a variety of limitations, including limited geometric accuracy, line-of-sight obstruction, and mismatch of the view angle with the surgeon's-eye view. This paper presents the development and characterization of a novel tracker configuration (referred to as "Tracker-on-C") intended to address such limitations by incorporating the tracker directly on the gantry of a mobile C-arm for fluoroscopy and cone-beam CT (CBCT). A video-based tracker (MicronTracker, Claron Technology Inc., Toronto, ON, Canada) was mounted on the gantry of a prototype mobile isocentric C-arm next to the flat-panel detector. To maintain registration within a dynamically moving reference frame (due to rotation of the C-arm), a reference marker consisting of 6 faces (referred to as a "hex-face marker") was developed to give visibility across the full range of C-arm rotation. Three primary functionalities were investigated: surgical tracking, generation of digitally reconstructed radiographs (DRRs) from the perspective of a tracked tool or the current C-arm angle, and augmentation of the tracker video scene with image, DRR, and planning data. Target registration error (TRE) was measured in comparison with the same tracker implemented in a conventional in-room configuration. Graphics processing unit (GPU)-accelerated DRRs were generated in real time as an assistant to C-arm positioning (i.e., positioning the C-arm such that target anatomy is in the field-of-view (FOV)), radiographic search (i.e., a virtual X-ray projection preview of target anatomy without X-ray exposure), and localization (i.e., visualizing the location of the surgical target or planning data). Video augmentation included superimposing tracker data, the X-ray FOV, DRRs, planning data, preoperative images, and/or intraoperative CBCT onto the video scene. Geometric accuracy was quantitatively evaluated in each case, and qualitative assessment of clinical feasibility was analyzed by an experienced and fellowship-trained orthopedic spine surgeon within a clinically realistic surgical setup of the Tracker-on-C. The Tracker-on-C configuration demonstrated improved TRE (0.87 ± 0.25) mm in comparison with a conventional in-room tracker setup (1.92 ± 0.71) mm (p < 0.0001) attributed primarily to improved depth resolution of the stereoscopic camera placed closer to the surgical field. The hex-face reference marker maintained registration across the 180° C-arm orbit (TRE = 0.70 ± 0.32 mm). DRRs generated from the perspective of the C-arm X-ray detector demonstrated sub- mm accuracy (0.37 ± 0.20 mm) in correspondence with the real X-ray image. Planning data and DRRs overlaid on the video scene exhibited accuracy of (0.59 ± 0.38) pixels and (0.66 ± 0.36) pixels, respectively. Preclinical assessment suggested potential utility of the Tracker-on-C in a spectrum of interventions, including improved line of sight, an assistant to C-arm positioning, and faster target localization, while reducing X-ray exposure time. The proposed tracker configuration demonstrated sub- mm TRE from the dynamic reference frame of a rotational C-arm through the use of the multi-face reference marker. Real-time DRRs and video augmentation from a natural perspective over the operating table assisted C-arm setup, simplified radiographic search and localization, and reduced fluoroscopy time. Incorporation of the proposed tracker configuration with C-arm CBCT guidance has the potential to simplify intraoperative registration, improve geometric accuracy, enhance visualization, and reduce radiation exposure.
  International Journal of Computer Assisted Radiology and Surgery 04/2012; 7(5):647-65. · 1.48 Impact Factor
• Article: TREK: an integrated system architecture for intraoperative cone-beam CT-guided surgery

  A. Uneri, S. Schafer, D. J. Mirota, S. Nithiananthan, Y. Otake, R. H. Taylor, J. H. Siewerdsen
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  ABSTRACT: PurposeA system architecture has been developed for integration of intraoperative 3D imaging [viz., mobile C-arm cone-beam CT (CBCT)] with surgical navigation (e.g., trackers, endoscopy, and preoperative image and planning data). The goal of this paper is to describe the architecture and its handling of a broad variety of data sources in modular tool development for streamlined use of CBCT guidance in application-specific surgical scenarios. MethodsThe architecture builds on two proven open-source software packages, namely the cisst package (Johns Hopkins University, Baltimore, MD) and 3D Slicer (Brigham and Women’s Hospital, Boston, MA), and combines data sources common to image-guided procedures with intraoperative 3D imaging. Integration at the software component level is achieved through language bindings to a scripting language (Python) and an object-oriented approach to abstract and simplify the use of devices with varying characteristics. The platform aims to minimize offline data processing and to expose quantitative tools that analyze and communicate factors of geometric precision online. Modular tools are defined to accomplish specific surgical tasks, demonstrated in three clinical scenarios (temporal bone, skull base, and spine surgery) that involve a progressively increased level of complexity in toolset requirements. ResultsThe resulting architecture (referred to as “TREK”) hosts a collection of modules developed according to application-specific surgical tasks, emphasizing streamlined integration with intraoperative CBCT. These include multi-modality image display; 3D-3D rigid and deformable registration to bring preoperative image and planning data to the most up-to-date CBCT; 3D-2D registration of planning and image data to real-time fluoroscopy; infrared, electromagnetic, and video-based trackers used individually or in hybrid arrangements; augmented overlay of image and planning data in endoscopic or in-room video; and real-time “virtual fluoroscopy” computed from GPU-accelerated digitally reconstructed radiographs (DRRs). Application in three preclinical scenarios (temporal bone, skull base, and spine surgery) demonstrates the utility of the modular, task-specific approach in progressively complex tasks. ConclusionsThe design and development of a system architecture for image-guided surgery has been reported, demonstrating enhanced utilization of intraoperative CBCT in surgical applications with vastly different requirements. The system integrates C-arm CBCT with a broad variety of data sources in a modular fashion that streamlines the interface to application-specific tools, accommodates distinct workflow scenarios, and accelerates testing and translation of novel toolsets to clinical use. The modular architecture was shown to adapt to and satisfy the requirements of distinct surgical scenarios from a common code-base, leveraging software components arising from over a decade of effort within the imaging and computer-assisted interventions community. KeywordsImage-guided surgery–Cone-beam CT–Intraoperative imaging–Surgical navigation–System architecture–Open-source software
  International Journal of Computer Assisted Radiology and Surgery 04/2012; 7(1):159-173. · 1.48 Impact Factor
• Article: Erratum to: TREK: an integrated system architecture for intraoperative cone-beam CT-guided surgery.

  A Uneri, S Schafer, D J Mirota, S Nithiananthan, Y Otake, R H Taylor, G L Gallia, A J Khanna, S Lee, D D Reh, J H Siewerdsen
  International Journal of Computer Assisted Radiology and Surgery 08/2011; · 1.48 Impact Factor
• Article: TREK: an integrated system architecture for intraoperative cone-beam CT-guided surgery.

  A Uneri, S Schafer, D J Mirota, S Nithiananthan, Y Otake, R H Taylor, G L Gallia, A J Khanna, S Lee, D D Reh, J H Siewerdsen
  [show abstract] [hide abstract]
  ABSTRACT: A system architecture has been developed for integration of intraoperative 3D imaging [viz., mobile C-arm cone-beam CT (CBCT)] with surgical navigation (e.g., trackers, endoscopy, and preoperative image and planning data). The goal of this paper is to describe the architecture and its handling of a broad variety of data sources in modular tool development for streamlined use of CBCT guidance in application-specific surgical scenarios. The architecture builds on two proven open-source software packages, namely the cisst package (Johns Hopkins University, Baltimore, MD) and 3D Slicer (Brigham and Women's Hospital, Boston, MA), and combines data sources common to image-guided procedures with intraoperative 3D imaging. Integration at the software component level is achieved through language bindings to a scripting language (Python) and an object-oriented approach to abstract and simplify the use of devices with varying characteristics. The platform aims to minimize offline data processing and to expose quantitative tools that analyze and communicate factors of geometric precision online. Modular tools are defined to accomplish specific surgical tasks, demonstrated in three clinical scenarios (temporal bone, skull base, and spine surgery) that involve a progressively increased level of complexity in toolset requirements. The resulting architecture (referred to as "TREK") hosts a collection of modules developed according to application-specific surgical tasks, emphasizing streamlined integration with intraoperative CBCT. These include multi-modality image display; 3D-3D rigid and deformable registration to bring preoperative image and planning data to the most up-to-date CBCT; 3D-2D registration of planning and image data to real-time fluoroscopy; infrared, electromagnetic, and video-based trackers used individually or in hybrid arrangements; augmented overlay of image and planning data in endoscopic or in-room video; and real-time "virtual fluoroscopy" computed from GPU-accelerated digitally reconstructed radiographs (DRRs). Application in three preclinical scenarios (temporal bone, skull base, and spine surgery) demonstrates the utility of the modular, task-specific approach in progressively complex tasks. The design and development of a system architecture for image-guided surgery has been reported, demonstrating enhanced utilization of intraoperative CBCT in surgical applications with vastly different requirements. The system integrates C-arm CBCT with a broad variety of data sources in a modular fashion that streamlines the interface to application-specific tools, accommodates distinct workflow scenarios, and accelerates testing and translation of novel toolsets to clinical use. The modular architecture was shown to adapt to and satisfy the requirements of distinct surgical scenarios from a common code-base, leveraging software components arising from over a decade of effort within the imaging and computer-assisted interventions community.
  International Journal of Computer Assisted Radiology and Surgery 07/2011; 7(1):159-73. · 1.48 Impact Factor
• Article: TREK: an integrated system architecture for intraoperative cone-beam CT guided surgery

  A. Uneri, S. Schafer, D.J. Mirota, S. Nithiananthan, Y. Otake, R.H. Taylor, G. Gallia, D. D. Reh, S. Lee, A. J. Khanna, J H. Siewerdsen
  Int J Comput Assist Radiol and Surg. 7(1):159-173.
• Conference Proceeding: Tracker-on-C for cone-beam CT-guided surgery: evaluation of geometric accuracy and clinical applications

  S. Reaungamornrat, Y. Otake, A. Uneri, S. Schafer, D. J. Mirota, S. Nithiananthan, J. W. Stayman, A. J. Khanna, D. D. Reh, G. L. Gallia, R. H. Taylor, J. H. Siewerdsen
  SPIE Medical Imaging;
• Article: An on-board surgical tracking and video augmentation system for C-arm image guidance

  S. Reaungamornrat, Y. Otake, A. Uneri, S. Schafer, D.J. Mirota, S. Nithiananthan, J.W. Stayman, G. Kleinszig, A.J. Khanna, R.H. Taylor, J.H. Siewerdsen
  International Journal of Computer Assisted Radiology and Surgery. In Press.
• Conference Proceeding: Tracker-on-C: A novel tracker configuration for image-guided therapy using a mobile C-arm

  S. Reaungamornrat, Y. Otake, A. Uneri, S. Schafer, J. W. Stayman, W. Zbijewski, D.J. Mirota, J. Yoo, S. Nithiananthan, A.J. Khanna, R. H. Taylor, J. H. Siewerdsen
  ISCAS;