Towards real-time 3D US-CT registration on the beating heart for guidance of minimally invasive cardiac interventions

Compared to conventional open-heart surgeries, minimally invasive cardiac interventions cause less trauma and sideeffects to patients. However, the direct view of surgical targets and tools is usually not available in minimally invasive procedures, which makes image-guided navigation systems essential. The choice of imaging modalities used in the navigation systems must consider the capability of imaging soft tissues, spatial and temporal resolution, compatibility and flexibility in the OR, and financial cost. In this paper, we propose a new means of guidance for minimally invasive cardiac interventions using 3D real-time ultrasound images to show the intra-operative heart motion together with preoperative CT image(s) employed to demonstrate high-quality 3D anatomical context. We also develop a method to register intra-operative ultrasound and pre-operative CT images in close to real-time. The registration method has two stages. In the first, anatomical features are segmented from the first frame of ultrasound images and the CT image(s). A feature based registration is used to align those features. The result of this is used as an initialization in the second stage, in which a mutual information based registration is used to register every ultrasound frame to the CT image(s). A GPU based implementation is used to accelerate the registration.

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