Biomedical subjects

E M Friets

Publications and source records attributed to E M Friets.

4 recordsLinked to original sources

PubMed1995

Curvature-based nonfiducial registration for the Frameless Stereotactic Operating Microscope.

The Frameless Stereotactic Operating Microscope permits information from CT and MRI scans to be displayed in the operating microscope in the proper scale and perspective without using a mechanical frame in the process, when the microscope is positioned over the surgical field. This registration is currently done using fiducials that must be present when the imaging scans are taken. A new technique, based on the theory of curvatures, has been developed as an alternative to the use of fiducials for the registration of a patient's head position during surgery with diagnostic images from CT or MRI. Surface curvatures are estimated from a trace of points of the surface of the skin, obtained from both the diagnostic images and an intraoperative nonimaging ultrasonic rangefinder. The point traces need not be identical or evenly spaced. Plots of the resulting curvature fields are compared visually and the alignment determined. Phantom testing, using a human skull, has resulted in a median alignment error of 1.95 mm. Testing using a human subject with clinically obtained data has resulted in alignment errors on the order of 7 mm.

Computers↗

PubMed1993

Extracranial application of the frameless stereotactic operating microscope: experience with lumbar spine.

The frameless stereotactic operating microscope has expanded the potential application of modern stereotaxis to procedures outside of the intracranial compartment by removing the constraint of a rigid frame. We studied seven patients all of whom had a history, examination, and imaging studies consistent with lumbosacral spinal pathology for which they subsequently underwent surgery with the operating microscope. The ability of the frameless stereotactic system with preoperative computed tomography data to locate the level of the lesion as well as define the boundary of the spinal pathology intraoperatively was assessed. In parallel with this application of the frameless system, we analyzed the relationship between the lumbar intervertebral disc spaces (L3-L4, L4-L5, L5-S1) and skin surface fiducials using lateral radiographs. In seven patients with extracranial cases (six herniated lumbar discs and one lumbar spondylolysis with Grade I spondylolisthesis) who underwent operations by this system, the accuracy of the digitization component of the system with respect to localization of an independent test fiducial was 3.28 mm (SD, 0.61). The accuracy of the entire system in locating the independent fiducial within the viewing plane was 6.05 mm (SD, 4.04). Disc space localization had a far greater error of 28.81 mm (SD, 7.49). There was no consistent pattern to the magnitude or direction of the displacement of the lumbar intervertebral discs with respect to the fiducial markers in the sagittal plane. Although accuracy at the level of the fiducial plane was similar to that of intracranial applications, paraspinal tissue and vertebral column deformations rendered poorer accuracy with deeper structures.

Adult↗

PubMed1989

The stereotactic operating microscope: accuracy refinement and clinical experience.

Accuracy of a stereotactic operating microscope, by which imaging data may be superimposed on the operative field without a stereotactic frame, has been most limited by the resolution of imaging information. Using newer algorithms and pilot pole calibration of the digitizer, an error in registration of 2 mm and in contour display of 3 mm has been demonstrated. Greatest utility of the system clinically has been in providing navigational guidance to small lesions undergoing resection.

Brain Neoplasms↗

PubMed1989

A frameless stereotaxic operating microscope for neurosurgery.

A new system, which we call the frameless stereotaxic operating microscope, is discussed. Its purpose is to display CT or other image data in the operating microscope in the correct scale, orientation, and position without the use of a stereotaxic frame. A nonimaging ultrasonic rangefinder allows the position of the operating microscope and the position of the patient to be determined. Discrete fiducial points on the patient's external anatomy are located in both image space and operating room space, linking the image data and the operating room. Physician-selected image information, e.g., tumor contours or guidance to predetermined targets, is projected through the optics of the operating microscope using a miniature cathode ray tube and a beam splitter. Projected images superpose the surgical field, reconstructed from image data to match the focal plane of the operating microscope. The algorithms on which the system is based are described, and the sources and effects of errors are discussed. The system's performance is simulated, providing an estimate of accuracy. Two phantoms are used to measure accuracy experimentally. Clinical results and observations are given.

Algorithms↗