1. IGT Meeting – CADDLab – November, 2005 Image-Guided Surgery Applications Julien Jomier The University of North Carolina at Chapel Hill

2. IGT Meeting – CADDLab – November, 2005 Outline ● TIPS Procedure CASILab ● NeuroSurgery Application BrainLab ● Liver Transplant Planning ● RF Liver Tumor Ablation CADDLab

3. IGT Meeting – CADDLab – November, 2005 TIPS Procedure Transjugular Intrahepatic Portosystemic Shunt CASILab @ UNC (Dr. Bullitt)

4. IGT Meeting – CADDLab – November, 2005 TIPS procedure Biplane Fluoroscopic Images 3D/2D Model-to-Image Registration Real-time tracking

5. IGT Meeting – CADDLab – November, 2005 TIPS : Registration Fluoro Images 3D Vascular Model Model-to- Image Registration Balloon Tracking Needle Tracking 3D Display

6. IGT Meeting – CADDLab – November, 2005 NeuroSurgery BrainLab VectorVision/VVLink VTK / CMake Brain/Spine surgery Intra-Operative Ultrasound Optical Tracker (NDI)

7. IGT Meeting – CADDLab – November, 2005 NeuroSurgery VVCranial MR/Patient registration: - Surface matching of the skull Surgical Navigation Tool tracking Head tracking

8. IGT Meeting – CADDLab – November, 2005 MR/US Fusion Manual alignment of tumor margins Add automatic non- rigid registration Model-to-Image registration

9. IGT Meeting – CADDLab – November, 2005 Liver Transplant Planning Define optimal cutting path preoperatively. Open-Surgery Bring the path in the OR Deformable Registration Ultrasound Annotation

10. IGT Meeting – CADDLab – November, 2005 Liver Transplant Planning

11. IGT Meeting – CADDLab – November, 2005 Liver Transplant Planning

12. IGT Meeting – CADDLab – November, 2005 RF Liver Tumor Ablation 40-50% of all lesions not seen using ultrasound. Options: - Open Surgery - CT/MR guided RFA - wait until lesion enlarges Ideal: Percutaneous treatment using US

13. IGT Meeting – CADDLab – November, 2005 RF Liver Tumor Ablation

14. IGT Meeting – CADDLab – November, 2005 RF Liver Tumor Ablation US Probe tracking via Ascension Flock of Birds Needle segmentation from US 3 Displays: - 3D - Needle point of view - Slice based

15. IGT Meeting – CADDLab – November, 2005 RFA Results US/MR model-to- image affine registration About 2 seconds Accuracy: - < 2mm translation - < 0.06rad rotation

16. IGT Meeting – CADDLab – November, 2005 3D US Reconstruction Reconstruct 3D Ultrasound volume from 2D tracked images Breathing/Heart beating Calibration needed

17. IGT Meeting – CADDLab – November, 2005 3D US Calibration T tracker z y x O Tracker US Probe US Image T TrackerToProbe y -z -x T model T ProbeToImage

18. IGT Meeting – CADDLab – November, 2005 US Reconstruction Results

19. IGT Meeting – CADDLab – November, 2005 Acknowledgments Dr. Sue Weeks Dr. Friedman Dr. Elizabeth Bullitt Stephen Aylward Amael Delaunoy

20. IGT Meeting – CADDLab – November, 2005 Tools Open Source Toolkits ITK/VTK IGSTK CMake SOViewers FLTK/Qt