Chair for Computer Aided Medical Procedures & Augmented Reality
Lehrstuhl für Informatikanwendungen in der Medizin & Augmented Reality

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M. Groher, T. F. Jakobs, N. Padoy, N. Navab
Planning and Intraoperative Visualization of Liver Catheterizations: New CTA Protocol and 2D-3D Registration Method
Academic Radiology 14 (11), pp.1324-1339. Special issue of MICCAI 2006 (bib)

Rationale and Objectives: 2D-3D registration for angiographic liver interventions is an unsolved problem mainly because of two reasons. First, a suitable protocol for Computed Tomography Angiography (CTA) to contrast liver arteries is not used in clinical practice. Second, in spite of a valuable body of research results in the neuroradiology community, an adequate registration algorithm which addresses the difficult task of 2D-3D alignment of abdominal vessel structures has not been developed yet. Materials and Methods: We address the first issue by introducing an angiographic CT scanning phase. The scan visualizes arteries similar to the vasculature captured with an intraoperative C-arm acquiring Digitally Subtracted Angiograms (DSAs). Furthermore, we propose a registration algorithm using the new CT phase that aligns arterial structures in two steps: a) Initialization of one corresponding feature using diameter information, b) optimization on three rotational and one translational parameters to register vessel structures that are represented as centerline graphs. We form a space of good features by iteratively creating new graphs from projected centerline images and by restricting the correspondence search only on branching points (the vertices) of the vessel tree. Results: We show convergence and robustness of the proposed algorithm on synthetic data, as well as head phantom and four consistent patient data sets. We compare our results to those of a recently proposed method. Moreover, we evaluate different visualization techniques and show that a transfer of planning information to intraoperative data is a benefit for interventional workflow. Conclusion: Introducing a new CTA protocol and a two-step 2D-3D registration algorithm, the proposed method creates a strong link between radiologists and interventionalists by bringing preoperative patient and planning information to interventional workflow.
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