Slicer IGT and Open IGT Link Nobuhiko Hata, PhD Sandy Wells, PhD Computation Core

National Center for Image-Guided Therapy www.ncigt.org Surgical Planning Lab, Harvard Medical School Surgical Navigation and Robotics Laboratory National Alliance for Medical Image Computing Intelligent Surgical Instrument Project, Japan

Slicer in IGT To facilitate application of state-of-art medical image processing in IGT IGT specific extension to support this translation

Software Design To maximize function commonalities among applications Brain (biopsy, craniotomy, NdYAG laser ablation) Prostate (brachytherapy, biopsy) Liver and kidney (Microwave, Cryo, laser ablation) Endoscopy (broncho-, neuro-, feto-scopy)

MRg Prostate Therapy Segmentation tool for Brachytherapy Planning and Biopsy Navigation for Biopsy Future FUS and Robot Applications Please highlight our effort to develop new SIGN with focus on tracker I/O. The effort enabled integration of shared tracker I/O tool to current slicer. Please also highlight the need for improving fast graphics from the video, which again is part of IGT-specific Slicer.

Role of Slicer in MRg Prostate Therapies DICOM image transfer Planning Scanner control Rigid and non-rigid image registration Pre-op MRI +Pre-procedural MRI +Intra-procedural MRI Radiology 220(1), 263-268, 2001

MR-guided laser ablation MRI Thermal image reconstruction in 3D Slicer Guidance with thermal images to minimize “uncooked” lesion New 3D temperature mapping from Imaging Core to be implemented in the future Demostrating: (1) thermal image overlayed on Sagital view,(2) uncooked lesion only visible in axial view available in Slcier, (3) leaving marker in uncooked lesion, (4) guiding additional needle to the uncooked lesion Movie prepared by Hata

MR-guided neurosurgery MRI-guided brain tumor surgery guided with fMRI and diffusion tensor tractography Toward Spatial Neuroinformatics for Functional Localization (P.I. Wells) Video: fMRI registered to intraop MRI using deofrormaable registration. Fused images are used in navigation. Top left, pre-crani SPGR and fmri, bottom left, after crani with deformed fmri, bottom right pre-operative T2 registered with non-deformed fmri. Movie prepared by Hata, Warfield, Golby

Open IGT Link Inter-device communication mechanism Enables exchange of coordinates, images, control commands Open protocol History Needs indentified during IGT Programming event in Dec, 2008 Design discussion during a NA-MIC programming event (Jan, 2008) Initial implementation by NIH-funded IGT researchers in Spring 2008

An example: MRg Prostate intervention Commercial Software Interface image visualization planning biopsy targets rad. dose brachy. seed targets image registration Pre-op ↔ intra-op multi-parametric (SSM) interventional image visualization (in room) RT image processing robot localization Robot calibration needle localization seed localization DICOM Server (?) MRI Host MRI Scanner Real-Time Image Controller image recon plane control SPLOT Raw Data Server SPLOT SPLOT RSP Modifier SPLOT Image Processor (?) Robot Controller Robotic Manipulator Driver Control Interface   ? Research Interface Image visualization Planning (biopsy targets) Image registration (pre ↔ intra) Interventional visualization RT image processing (fiducial)

Endorsement by IGT research community DelNido BRP Surgical robotics research community

Open IGT Link and IGSTK IGSTK is a software interface to commercial trackers NDI Polaris, NDI Aurora, Ascension Flock of Birds, and Ascension Microbird IGSTK has Open IGT Link interface. Access to all IGSTK supported devices in Slicer 3 Work was done by Kitware, Georgetown, SPL with funding from NA-MIC collaboration grant (PI Cleary)

Intra-operative Seeding of Tractography Use tracking device to Seed tractography at the location of neurosurgical lesion Internal collaboration with Neurosurgery Core

Conclusion 3D Slicer Open IGT Link Future Plan Useful tool for IGT software development Facilitates collaboration and dissemination Open IGT Link New development from Year 3 Community building for IGT scientists working with variety of vendors and applications Future Plan Continuing effort to extend Slicer 3 for new IGT Service/dissemination