Healthcare Technology Letters (Oct 2018)

Augmented reality-based feedback for technician-in-the-loop C-arm repositioning

  • Mathias Unberath,
  • Javad Fotouhi,
  • Javad Fotouhi,
  • Jonas Hajek,
  • Andreas Maier,
  • Greg Osgood,
  • Russell Taylor,
  • Mehran Armand,
  • Nassir Navab

DOI
https://doi.org/10.1049/htl.2018.5066

Abstract

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Interventional C-arm imaging is crucial to percutaneous orthopedic procedures as it enables the surgeon to monitor the progress of surgery on the anatomy level. Minimally invasive interventions require repeated acquisition of X-ray images from different anatomical views to verify tool placement. Achieving and reproducing these views often comes at the cost of increased surgical time and radiation. We propose a marker-free ‘technician-in-the-loop’ Augmented Reality (AR) solution for C-arm repositioning. The X-ray technician operating the C-arm interventionally is equipped with a head-mounted display system capable of recording desired C-arm poses in 3D via an integrated infrared sensor. For C-arm repositioning to a target view, the recorded pose is restored as a virtual object and visualized in an AR environment, serving as a perceptual reference for the technician. Our proof-of-principle findings from a simulated trauma surgery indicate that the proposed system can decrease the 2.76 X-ray images required for re-aligning the scanner with an intra-operatively recorded C-arm view down to zero, suggesting substantial reductions of radiation dose. The proposed AR solution is a first step towards facilitating communication between the surgeon and the surgical staff, improving the quality of surgical image acquisition, and enabling context-aware guidance for surgery rooms of the future.

Keywords