Real-time Virtual Intraoperative CT for Image Guided Surgery

Abstract. Purpose: This paper presents a scheme for generating virtual intraoperative CT scans in order to improve surgical completeness in Endoscopic Sinus Surgeries (ESS). Approach: The work presents three methods, the tip motion-based, the tip trajectory-based, and the instrument based, along with non-parametric smoothing and Gaussian Process Regression, for virtual intraoperative CT generation. Results: The proposed methods studied and compared on ESS performed on cadavers. Surgical results show all three methods improve the Dice Similarity Coefficients > 86%, with F-score > 92% and precision > 89.91%. The tip trajectory-based method was found to have best performance and reached 96.87% precision in surgical completeness evaluation. Conclusions: This work demonstrated that virtual intraoperative CT scans improves the consistency between the actual surgical scene and the reference model, and improves surgical completeness in ESS. Comparing with actual intraoperative CT scans, the proposed scheme has no impact on existing surgical protocols, does not require extra hardware other than the one is already available in most ESS overcome the high costs, the repeated radiation, and the elongated anesthesia caused by actual intraoperative CTs, and is practical in ESS.