Design and evaluation of a system for microscope-assisted guided interventions (MAGI)

Abstract

The problem of providing surgical navigation using image overlays on the operative scene can be split into four main tasks - calibration of the optical system; registration of preoperative images to the patient; tracking of the display system and patient and display using a suitable visualisation scheme. To achieve a convincing result in the magnified view through the operating microscope high alignment accuracy is required. We have simulated our entire system to establish the major sources of error. We have improved each of the stages involved. The microscope calibration process has been automated. We have introduced bone-implanted markers for registration and incorporated a locking acrylic dental stent (LADS) for patient tracking and/or registration. These improvements have significantly increased the alignment accuracy of our overlays. LADS repositioning on volunteers showed a mean target registration error of 0.7mm. Phantom accuracy is 0.3-0.5mm and clinical overlay errors were 0.5-1.0mm on the bone fiducials and 0.5-4mm on target structures. We have improved the graphical representation of the stereo overlays. The resulting system provides 3D surgical navigation for microscope-assisted guided interventions (MAGI).