A distributed system for 3D anatomical structures visualization and surgical planning
The progress made in medical imaging has led to enhanced diagnostic capabilities. Nevertheless, the analysis of the complex information contained in a set of 2D CT-Scan or MRI slices is a hard task : physicians have to mentally rebuild the images to obtai
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A distributed system for 3D anatomical structures visualization and surgical planning a
C. Koehl", L. Solera , J. Marescaux a Ircad/Eits, 1 Place de l'hopital67091 Strasbourg France
Keywords: Real-time 3D visualization, surgical simulation and training, pre- and intraoperative imaging/visualization
1. Introduction The progress made in medical imaging has led to enhanced diagnostic capabilities. Nevertheless, the analysis of the complex information contained in a set of20 CT-Scan or MRI slices is a hard task: physicians have to mentally rebuild the images to obtain a 3D view of a patient's organ. The proposed system is a secure PACS (Picture Archiving and Communication System) including a 3D visualization interface consists of a set of tools which helps the physician in his pre- and intra-operative strategy. 2. Methods The present system is a distributed architecture allowing secure storage and 3D visualization of anatomical structures reconstructed from CT-Scan and MRI images. Patient information and data are stored in distant databases accessible through the hospital network by using a user-friendly visualization interface. This surgical planning tool consists of : a virtual resecting tool allowing for simulation of surgical procedures, permitting insertion and manipulation of virtual laparoscopic tools, display of security margins, calculating 3D distance, and computation of organ volume. Finally, one major advantage of the visualization interface is that it works on a simple laptop, which can be temporally disconnected from the hospital network, allowing for consultation of reconstructed exams in the operating room. 3. Results In the scope of hepatic surgery, the 3D real-time navigation function allows for understanding of liver anatomy, and exact location, size and volume computation of liver tumors of a given patient. The margin tool is used to appreciate the relation of tumors to hepatic and portal veins, and to facilitate therapeutic decision making. The resection tool allows the surgeon to precisely plan, preoperatively, his operative strategy. In the anesthesia field, the system is able to simulate, from an CT airway exam, a difficult endotracheal intubation. While these tools are presently being used for interventions like radiology imaging-guided puncture or radio-frequency ablation, cholangiography analysis or virtual colonoscopy navigation, they have the potential to be used for any other organ. 4. Conclusions This system, which is a very helpful surgical planning tool, can also form the foundation of augmented reality environments, and can already be used in the scope of computer assisted teaching. Moreover, coupled to force feedback devices, it can be used in realistic surgical simulation systems or in robot-assisted surgery.
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