Fluorescent Fiducial Image Registration for Deformable Tissue
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Solution Overview
Problem
Existing methods for registering medical scan images before surgery with real-time images during surgery are unreliable, especially when dealing with highly deformable or variable body portions due to time, positioning, or internal/external influences.
Innovation Solution
An augmented reality system that captures and processes both visible and infrared light images in real-time, using fluorescent fiducials to enhance visibility through biological tissue, and allows for re-registration to account for tissue deformations during surgery, enabling precise overlay of preoperative scan images with live surgical images.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If visible light imaging is used for registration, then the surgeon can directly view the images, but fluorescent fiducials cannot be seen through biological tissue
Solution Approach 1:
The imaging system is segmented into two separate channels: a visible light camera for surgical visualization and an infrared camera for fiducial detection. This segmentation allows each channel to optimize for its specific function, with the infrared channel penetrating tissue to detect fluorescent fiducials while the visible light channel provides the surgeon with direct visual feedback.
Solution Approach 2:
Fluorescent fiducials serve as intermediaries that can be detected by infrared light through biological tissue. These fiducials absorb infrared excitation light and emit fluorescent infrared light, enabling indirect visualization of fiducial positions through the tissue barrier that blocks visible light.
2Measurement precision
If preoperative scan images are registered with live surgical images, then surgical accuracy can be improved, but tissue deformations during surgery cause misalignment
Solution Approach 1:
The registration system transitions from static preoperative image alignment to dynamic real-time registration. The system continuously captures infrared images during surgery, detects fiducial positions, and updates the transformation matrix dynamically to compensate for tissue deformations caused by patient positioning, breathing, or surgical manipulation.
Solution Approach 2:
The system implements feedback by continuously monitoring fiducial positions through infrared imaging and using this information to adjust and refine the registration between preoperative and live surgical images. This closed-loop approach allows the system to adapt to ongoing tissue deformations and maintain accurate alignment throughout the procedure.
3Reliability
If multiple imaging channels are used for registration, then detection reliability improves, but device complexity increases
Solution Approach 1:
The infrared imaging system serves multiple functions: it detects fluorescent fiducials for registration, visualizes tissue structures with infrared transparency, and provides real-time feedback on fiducial positions. This multi-functionality reduces the need for separate specialized devices while maintaining high registration reliability.
Solution Approach 2:
The system merges the surgical imaging and fiducial detection functions into a unified infrared imaging platform. By combining these functions that share common infrastructure (infrared camera, excitation light source, image processing), the system achieves high reliability without proportionally increasing complexity.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach provides reliable and precise registration of medical scan images with live surgical images, even in deformable tissues, reducing the risk of misalignment and improving surgical accuracy by using infrared light to highlight fiducials and relying on tissue structures for alignment, thus enhancing surgical outcomes.
Implementation Method 1
A fiducial device is provided which comprises at least two marks adapted to emit infrared light
Implementation Method 2
The excitation light and the visible and/or infrared light of the fluorescent material placed in or on the fiducial device both have wavelengths for which the biological tissue, and in particular blood, is transparent
Data Source
AI summary
Embodiments of the invention provide systems and methods for providing augmented reality to a surgeon with the steps of acquiring at least one preoperative medical scan image of a region of interest in which the surgery is to be performed and introducing a fiducial device non-invasively or minimal invasively into a body lumen present in the region of interest of a patient. The fiducial device will be in particular introduced into a lumen, which can be clearly identified in the medical scan image. The fiducial device is adapted to emit infrared light either by using infrared light source or by using fluorescent material placed in or in the fiducial device ad to be excited by illumination light or exciting light. After acquiring at least one imaging light live image and one infrared live image the tissue structure of the body lumen with the fiducial device placed therein is clearly detectable within the live image and can reliably registered and matched to the scan image for presenting the overlaid images and to the surgeon.