Intra-operative prostate motion tracking using surface markers for robot-assisted laparoscopic radical prostatectomy

Published in SPIE Medical Imaging, 2012

Recommended citation: Esteghamatian M, Sarkar K, Pautler SE, Chen ECS, Peters TM, (2012). "Intra-operative prostate motion tracking using surface markers for robot-assisted laparoscopic radical prostatectomy"; in SPIE Medical Imaging: Image-Guided Procedures, Robotic Interventions, and Modeling, 83162N, pp. 795-802. https://doi.org/10.1117/12.911151

Radical prostatectomy surgery (RP) is the gold standard for treatment of localized prostate cancer (PCa). Recently, emergence of minimally invasive techniques such as Laparoscopic Radical Prostatectomy (LRP) and Robot-Assisted Laparoscopic Radical Prostatectomy (RARP) has improved the outcomes for prostatectomy. However, it remains difficult for the surgeons to make informed decisions regarding resection margins and nerve sparing since the location of the tumor within the organ is not usually visible in a laparoscopic view. While MRI enables visualization of the salient structures and cancer foci, its efficacy in LRP is reduced unless it is fused into a stereoscopic view such that homologous structures overlap. Registration of the MRI image and peri-operative ultrasound image using a tracked probe can potentially be exploited to bring the pre-operative information into alignment with the patient coordinate system during the procedure. While doing so, prostate motion needs to be compensated in real-time to synchronize the stereoscopic view with the pre-operative MRI during the prostatectomy procedure. In this study, a point-based stereoscopic tracking technique is investigated to compensate for rigid prostate motion so that the same motion can be applied to the pre-operative images. This method benefits from stereoscopic tracking of the surface markers implanted over the surface of the prostate phantom. The average target registration error using this approach was 3.25±1.43mm.

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