
Marina CarboneUniversity of Pisa | UNIPI · Department of Information Engineering and EndoCAS - Department of Translational Research on New Technologies in Medicine and Surgery
Marina Carbone
PhD MSc Biomedical Engineer
About
76
Publications
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Introduction
Marina Carbone earned a master's in Biomedical Engineering with honors from the University of Pisa in 2009. She attained her Ph.D. in Innovative Technologies from Scuola Superiore Sant'Anna, Pisa in 2013, focusing on surgical navigation and robotics. Since 2009, she's been at the EndoCAS center for computer-assisted surgery, and joined UNIPI's Department of Information Eng. in 2017. Her research focus is on biomedical imaging, augmented reality, surgical navigation, and simulation/training.
Additional affiliations
January 2012 - present
Education
November 2009 - July 2013
September 2006 - June 2009
Publications
Publications (76)
Wearable augmented reality in neurosurgery offers significant advantages by enabling the visualization of navigation information directly on the patient, seamlessly integrating virtual data with the real surgical field. This ergonomic approach can facilitate a more intuitive understanding of spatial relationships and guidance cues, potentially redu...
Rhinoplasty is one of the major surgical procedures most popular and it is generally performed modelling the internal bones and cartilage using a closed approach to reduce the damage of soft tissue, whose final shape is determined by means of their new settlement over the internal remodelled rigid structures. An optimal planning, achievable thanks...
Neuronavigation is integral to modern neurosurgery. Clinical studies demonstrate its effectiveness. The primary tracking modalities in neurosurgical navigation are optical tracking systems (OTS) and electromagnetic tracking systems (EMTS). OTS remains the gold standard due to its accuracy and reliability. However, inherent inaccuracies due to brain...
Simulation in the medical field provides interactive training system set in a realistic clinical scene for training healthcare staff to increase patient safety [1]. The advantages of training by simulation are the opportunity for the learner to have reproducible and standardised experiences where they can participate actively and not as a passive o...
Pedicle screw fixation (PSF) demands rigorous training to mitigate the risk of severe neurovascular complications arising from screw misplacement. This paper introduces a patient-specific phantom designed for PSF training, extending a portion of the learning process beyond the confines of the surgical room. Six phantoms of the thoracolumbar region...
Achieving and maintaining proper image registration accuracy is an open challenge of image-guided surgery. This work explores and assesses the efficacy of a registration sanity check method for augmented reality-guided navigation (AR-RSC), based on the visual inspection of virtual 3D models of landmarks. We analyze the AR-RSC sensitivity and specif...
Giant Cell Tumor of Bone is a benign tumor with high local aggressive expansion, which, in rare cases, spreads metastasis. Surgical treatment, which often consists of wide curettage to reduce recurrence risk, can lower the quality of life for those affected. Along with aggressive surgery, adjuvant intraoperative techniques have been implemented suc...
Research studies show that serious games can increase patient motivation regardless of age or illness and be an affordable and promising solution with respect to conventional physiotherapy. In this paper, we present the latest evolution of our system for shoulder rehabilitation based on hand-finger tracking and projected augmented reality. This ver...
This contribution describes some activities promoted by a group of roboticists from Istituto Italiano di Tecnologia and Università di Pisa in response to the pandemic. In particular, a “do-it-yourself” (DIY) open-source service and related hardware/products will be illustrated to help combat some consequences of the Covid 19 emergency. The project...
Biomedical engineering integrates a variety of applied sciences with life sciences to improve human health and reduce the invasiveness of surgical procedures. Technological advances, achieved through biomedical engineering, have contributed to significant improvements in the field of vascular and endovascular surgery. This paper aims to review the...
In the field of image-guided surgery, Augmented Reality wearable displays are a widely studied and documented technology for their ability to provide egocentric vision together with the overlap between real and virtual content. In particular, optical see-through (OST) displays have the advantage of maintaining visual perception of the real world. H...
Patient-specific templates (PST) have become a useful tool for guiding osteotomy in complex surgical scenarios such as pelvic resections. The design of the surgical template results in sharper, less jagged resection margins than freehand cuts. However, their correct placement can become difficult in some anatomical regions and cannot be verified du...
In recent years, huge progress has been made in the management of brain tumors, due to the availability of imaging devices, which provide fundamental anatomical and pathological information not only for diagnostic purposes [...]
Serious games are games in which the main goal is not entertainment, but a serious purpose ranging from the acquisition of knowledge to interactive training, to name just a few [...]
In the context of a European project, we identified over 150 requirements for the development of an augmented reality (AR) head-mounted display (HMD) specifically tailored to support highly challenging manual surgical procedures. The requirements were established by surgeons from different specialties and by industrial players working in the surgic...
In the context of image-guided surgery, augmented reality (AR) represents a ground-breaking enticing improvement, mostly when paired with wearability in the case of open surgery. Commercially available AR head-mounted displays (HMDs), designed for general purposes, are increasingly used outside their indications to develop surgical guidance applica...
Visual augmented reality (AR) headsets have the potential to enhance surgical navigation by providing physicians with an egocentric visualization interface capable of seamlessly blending the virtual navigation aid with the real surgical scenario. However, technological and human-factor limitations still hinder the routine use of commercial AR heads...
Wearable Video See-Through (VST) devices for Augmented Reality (AR) and for obtaining a Magnified View are taking hold in the medical and surgical fields. However, these devices are not yet usable in daily clinical practice, due to focusing problems and a limited depth of field. This study investigates the use of liquid-lens optics to create an aut...
INTRODUCTION: Mastering surgery and treatments of spine-related conditions require long training times. The need for cost-effective structured training is raising. Training through simulation can potentially revolutionize the standard paradigm if proper simulators are developed and tested. The purpose of this review was to evaluate the literature l...
In situ fenestration of stent-graft represents a potential option for the treatment of aortic diseases in patients unsuitable for standard endovascular repair. The best fenestration strategy to restore perfusion of collateral vessels after their coverage by an endograft depends mainly on the anatomical area. Several tools are employed as fenestrati...
Simulation-based medical training is considered an effective tool to acquire/refine technical skills, mitigating the ethical issues of Halsted’s model. This review aims at evaluating the literature on medical simulation techniques based on augmented reality (AR), mixed reality (MR), and hybrid approaches. The research identified 23 articles that me...
This contribution describes a case study of a “do-it-yourself” (DIY) opensource service and related product to help combating the COVID-19 emergency. It illustrates the birth of LHF Connect, a project designed to facilitate communication between patients isolated in COVID-19 hospitals’ ward and their relatives. LHF Connect is a teleoperated robot t...
Background:
In the context of guided surgery, augmented reality (AR) represents a groundbreaking improvement. The Video and Optical See-Through Augmented Reality Surgical System (VOSTARS) is a new AR wearable head-mounted display (HMD), recently developed as an advanced navigation tool for maxillofacial and plastic surgery and other non-endoscopic...
In pedicle screws placement using a free-hand technique or a fluoroscopic guided technique the main difficulties are facing to the bone morphology (i.e in deformity cases) and it could be easily reproduced in a patient’s specific spine simulator (we can choose the case). The aim of this work is to evaluate the use of 3D printed patient- specific mo...
In the last years also in orthopedic surgery, there was an increasing interest in the development of surgical simulators using methods of additive manufacturing combined or not with augmented reality systems (hybrid simulators). Aim of this work was to evaluate the use of a new patient’s specific tibial plateau fractures simulator for surgical trai...
Augmented reality (AR) head-mounted displays (HMDs) combine the user's natural view of the real world with virtual data. Thus, they might be particularly suited to guide manual tasks as in computer-aided-surgery.
However, the typical focal plane of commercial devices is outside the user's peripersonal space (i.e. the space containing reachable obje...
Background:
Virtual reality is becoming popular in the rehabilitation field thanks to the several advantages it can offer to patients and physicians. Indeed, serious games can: motivate and engage the patient; offer different levels of challenge and difficulty based on the patient baseline, and integrate objective measures of the patient's perform...
Augmented reality (AR) Head-Mounted Displays (HMDs) are emerging as the most efficient output medium to support manual tasks performed under direct vision. Despite that, technological and human-factor limitations still hinder their routine use for aiding high-precision manual tasks in the peripersonal space. To overcome such limitations, in this wo...
The focal length of available optical see-through (OST) head-mounted displays (HMDs) is at least 2 m therefore, during manual tasks, the user eye cannot keep in focus both the virtual and real content at the same time. Another perceptual limitation is related to the vergence-accommodation conflict (VAC), this latter being present in binocular visio...
Literature shows an increasing interest for the development of augmented reality (AR) applications in several fields, including rehabilitation. Current studies show the need for new rehabilitation tools for upper extremity, since traditional interventions are less effective than in other body regions. This review aims at: Studying to what extent AR...
In non-urban scenarios: rural areas or small cities, there is often a limited access to specialistic healthcare due to the inherent challenges associated with recruitment, retention, and access to healthcare professionals. Telemedicine is an economical and effective way to address this problem. In this research, we developed a framework for real-ti...
In mini-invasive surgery and in endoscopic procedures, the surgeon operates without a direct visualization of the patient’s anatomy. In image-guided surgery, solutions based on wearable augmented reality (AR) represent the most promising ones. The authors describe the characteristics that an ideal Head Mounted Display (HMD) must have to guarantee s...
Background:
Minimally-invasive sacrocolpopexy is the gold standard procedure for advanced apical prolapse. Nonetheless, sacrocolpopexy has potential serious complications leading many surgeons to avoid this excellent surgical procedure. To overcome these limitations, preoperative planning with 3D models of the female pelvis is proposed. The aim of...
Aim: In recent years the interest in structured training programs in endovascular surgical procedures has increased. In this study we assess face, content, and construct validity of a simulator to teach basic skills of endovascular surgery.
Material and methods: A cohort of 21 medical students, 26 residents, and 14 expert surgeons participated in t...
Neuronavigation has become an essential neurosurgical tool in pursuing minimal invasiveness and maximal safety, even though it has several technical limitations. Augmented reality (AR) neuronavigation is a significant advance, providing a real-time updated 3D virtual model of anatomical details, overlaid on the real surgical field. Currently, only...
In the context of Augmented Reality (AR), industrial pioneers and early adopters have considered the wearable optical see-through (OST) displays as proper and effective tools in applications spanning from manufacturing and maintenance up to the entertainment field and the medical area, because they provide the user with an egocentric viewpoint main...
ABSTRACT
Purpose: Benefits of minimally invasive neurosurgery mandate the development of ergonomic
paradigms for neuronavigation. Augmented Reality (AR) systems can overcome the shortcomings
of commercial neuronavigators. The aim of this work is to apply a novel AR system, based on a
head-mounted stereoscopic video see-through display, as an aid in...
This paper describes the development of the prototype of an Augmented Reality based tele-consultation platform settled with a wearable video see through Head Mounted Display (HMD) with the aim to provide specialist consult to low specialist remote area without the need to move the patient. The platform prototype has the donning advantage that gives...
In mini-invasive surgery, the surgeon operates without a direct visualization of the patient’s anatomy. In image-guided surgery, solutions based on augmented reality (AR) represent the most promising ones. The aim of this study was to evaluate the efficacy of a new wearable AR system as aid in the performance of percutaneous procedures in spine sur...
Purpose
In this work we provide measurements of speed of sound (SoS) and acoustic impedance (Z) of some doped/non-doped rubber-based materials dedicated to the development of ultrasound phantoms. These data are expected to be useful for speeding-up the preparation of multi-organ phantoms which show similar echogenicity to real tissues.
Methods
Diff...
Currently, Pedicle screws are positioned using a freehand technique or under fluoroscopic guidance. Although computer navigation has improved its accuracy over the last years, image guided navigation has still little use among physicians for orthopaedic surgeries. This is because computer assisted surgeries are very expensive, specially the require...
Live Surgery is today an integral component of surgical training programs and innovative surgical technique dissemination. However, the increasing pressure to maintain efficiency and reduce surgical risks has raised the need for structured training sessions through simulation technologies. Simulation has the potential to overcome several limitation...
Currently the learning model for ultrasound imaging diagnosis and intervention follows a traditional approach based on learning by doing but this model exposes the patient to the whole learning curve of the novice. In order to enable training in a safe environment without compromising patient's health we have developed and demonstrated face, conten...
In recent years the clinical interest for structured training in endovascular procedures has increased. Such procedures respect the physical integrity of the patient and at the same time ensure good therapeutic results. This study describes the development and testing of the B.E.S.T. (Basic Endovascular Skills Trainer) simulator. The B.E.S.T is an...
Surgical simulation based on augmented reality (AR), mixing the benefits of physical and virtual simulation, represents a step forward in surgical training. However, available systems are unable to update the virtual anatomy following deformations impressed on actual anatomy.
A proof-of-concept solution is described providing AR visualization of hi...
Introduction. Pedicle screw fixation to stabilize lumbar spinal fusion has become the gold standard for posterior stabilization. Computer Assisted systems allow to increase the accuracy of pedicle screw placement, but they are used only by few surgeons due to the costs and troubles related to their use. An alternative image guided approach, less ex...
Patient-specific 3D models obtained by the segmentation of volumetric diagnostic images play an increasingly important role in surgical planning. Surgeons use the virtual models reconstructed through segmentation to plan challenging surgeries. Many solutions exist for the different anatomical districts and surgical interventions. The possibility to...
Purpose:
An anatomically realistic ultrasound liver phantom with tissue-specific distinct signal properties is needed for training of novices in diagnostic and interventional procedures. The main objective of this work was development and testing of a new durable liver ultrasound training phantom for use with a hybrid simulator.
Methods:
A liver...
Introduction. In mini-invasive surgery the surgeon performs the procedure under medical imaging guidance without a direct visualization of the patient’s anatomy. This fact has lately inspired several research activities among these, Augmented Reality (AR) systems represent the most promising ones. The aim of the study was the evaluation of the effi...
Background
Currently, pedicle screws are positioned using a free-hand technique or under fluoroscopic guidance, with error in the range 10-40%, depending on the skill of the surgeon. Methods
After spine CT acquisition, each vertebra is segmented and the surgeon plans screw positioning in a virtual environment, then the template is designed around t...
In this paper a mechanical characterization of low cost and simply available materials to build efficient anthropomorphic ultrasound elastography phantoms is described. The class of silicone materials was selected because of their deformability, durability and the possibility of reproducing specific tissue properties and shapes. Innovative formulat...
The evolution of surgical robotics is following the progress of developments in Minimally Invasive Surgery (MIS), which is moving towards Single-Incision Laparoscopic Surgery (SILS) procedures. The complexity of these techniques has favored the introduction of robotic surgical systems. New bimanual robots, which are completely inserted into the pat...
In this work a continuum model for high frequency poroelastic longitudinal waves in hydrogels is presented. A viscoelastic force describing the interaction between the polymer network and the bounded water present in such materials is introduced. The model is tested by means of ultrasound wave speed and attenuation measurements in polyvinylalcohol...
Purpose Elastosonography (ES) is an ultrasound (US) technique which allows to evaluate elastic properties of tissues under external compression [1] and has been first proposed in the 1990' s for the early diagnosis of breast cancer. ES phantoms are useful to test and optimize the perfonnance of ES devices and for training purposes but also to valid...
Using practical examples, this report aims to highlight the clinical value of patient-specific three-dimensional (3D) models, obtained segmenting multidetector computed tomography (MDCT) images, for preoperative planning in general surgery.
In this study, segmentation and 3D model generation were performed using a semiautomatic tool developed in th...
According to literature evidences, simulation is of utmost importance for training purposes and for innovative surgical strategies assessment. Nowadays the market offers mainly two kind of simulators: rubber anatomies or virtual environments, each one with advantages and drawbacks. In this paper we describe a strategy to develop patientspecific sim...
According to literature evidence, simulation is of the utmost importance for training and innovative surgical strategies assessment. At present commercial physical simulators are limited to single or only a few anatomical structures and these are often just standard anatomies.
This paper describes a strategy to produce patient-specific abdominal si...
Background According to literature evidence, simulation is of the utmost importance for training and innovative surgical strategies assessment. At present commercial physical simulators are limited to single or only a few anatomical structures and these are often just standard anatomies.
According to literature evidences, simulation is of utmost importance for training purposes and for innovative surgical strategies assessment. Nowadays the market offers mainly two kind of simulators: rubber anatomies or virtual environments, each one with advantages and drawbacks.
In this paper we describe a strategy to develop patient-specific si...
In this work a continuum model for high frequency poroelastic longitudinal waves in hydrogels is presented. A viscoelastic force describing the interaction between the polymer network and the bounded water present in such materials is introduced. The model is tested by means of ultrasound wave speed and attenuation measurements in polyvinylalcohol...
In the present paper a continuum poroelastic model for high frequency acoustic waves in hydrogels has been developed. The model has been used to obtain the acoustic longitudinal wave equation for ultrasound.In order to obtain a satisfactory model for hydrogels, a viscoelastic force describing the interaction between the polymer network of the matri...