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Towards real-time, tracker-less 3D ultrasound guidance for spine anaesthesia

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Epidural needle insertions and facet joint injections play an important role in spine anaesthesia. The main challenge of safe needle insertion is the deep location of the target, resulting in a narrow and small insertion channel close to sensitive anatomy. Recent approaches utilizing ultrasound (US) as a low-cost and widely available guiding modality are promising but have yet to become routinely used in clinical practice due to the difficulty in interpreting US images, their limited view of the internal anatomy of the spine, and/or inclusion of cost-intensive tracking hardware which impacts the clinical workflow.

Methods

We propose a novel guidance system for spine anaesthesia. An efficient implementation allows us to continuously align and overlay a statistical model of the lumbar spine on the live 3D US stream without making use of additional tracking hardware. The system is evaluated in vivo on 12 volunteers.

Results

The in vivo study showed that the anatomical features of the epidural space and the facet joints could be continuously located, at a volume rate of 0.5 Hz, within an accuracy of 3 and 7 mm, respectively.

Conclusions

A novel guidance system for spine anaesthesia has been presented which augments a live 3D US stream with detailed anatomical information of the spine. Results from an in vivo study indicate that the proposed system has potential for assisting the physician in quickly finding the target structure and planning a safe insertion trajectory in the spine.

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Notes

  1. 3D Slicer, http://www.slicer.org.

  2. PLUS user manual: Volume reconstruction algorithm, http://perk-software.cs.queensu.ca/plus/doc/nightly/user/AlgorithmVolumeReconstruction.html.

  3. Intel Math Kernel Library, https://software.intel.com/en-us/intel-mkl.

  4. The OpenMP API specification for parallel programming, http://openmp.org/wp.

  5. Freehand tracked ultrasound calibration application (fCal), http://perk-software.cs.queensu.ca/plus/doc/nightly/user/ApplicationfCal.html.

  6. vtkTimerLog, http://www.vtk.org/doc/nightly/html/classvtkTimerLog.html.

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Acknowledgments

This work was supported in part by the Natural Sciences and Engineering Research Council (NSERC) and in part by the Canadian Institutes of Health Research (CIHR).

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Authors and Affiliations

  1. School of Computer Science and Communication, KTH Royal Institute of Technology, Stockholm, Sweden

    Mikael Brudfors & Atsuto Maki

  2. Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada

    Alexander Seitel, Abtin Rasoulian, Robert N. Rohling & Purang Abolmaesumi

  3. Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada

    Robert N. Rohling

  4. Laboratory for Percutaneous Surgery, School of Computing, Queens University, Kingston, ON, Canada

    Andras Lasso

  5. Department of Ultrasound, Women’s Hospital, Vancouver, BC, Canada

    Victoria A. Lessoway

  6. Department of Anesthesia, St. Pauls Hospital, Vancouver, BC, Canada

    Jill Osborn

Authors
  1. Mikael Brudfors
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  2. Alexander Seitel
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  3. Abtin Rasoulian
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  4. Andras Lasso
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  7. Atsuto Maki
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Correspondence to Mikael Brudfors.

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Brudfors, M., Seitel, A., Rasoulian, A. et al. Towards real-time, tracker-less 3D ultrasound guidance for spine anaesthesia. Int J CARS 10, 855–865 (2015). https://doi.org/10.1007/s11548-015-1206-1

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  • DOI: https://doi.org/10.1007/s11548-015-1206-1

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