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  • Title: Experimental validation of predicted application accuracies for computer-assisted (CAS) intraoperative navigation with paired-point registration.
    Author: Perwög M, Bardosi Z, Freysinger W.
    Journal: Int J Comput Assist Radiol Surg; 2018 Mar; 13(3):425-441. PubMed ID: 28801767.
    Abstract:
    PURPOSE: The target registration error (TRE) is a crucial parameter to estimate the potential usefulness of computer-assisted navigation intraoperatively. Both image-to-patient registration on base of rigid-body registration and TRE prediction methods are available for spatially isotropic and anisotropic data. This study presents a thorough validation of data obtained in an experimental operating room setting with CT images. METHODS: Optical tracking was used to register a plastic skull, an anatomic specimen, and a volunteer to their respective CT images. Plastic skull and anatomic specimen had implanted bone fiducials for registration; the volunteer was registered with anatomic landmarks. Fiducial localization error, fiducial registration error, and total target error (TTE) were measured; the TTE was compared to isotropic and anisotropic error prediction models. Numerical simulations of the experiment were done additionally. RESULTS: The user localization error and the TTE were measured and calculated using predictions, both leading to results as expected for anatomic landmarks and screws used as fiducials. TRE/TTE is submillimetric for the plastic skull and the anatomic specimen. In the experimental data a medium correlation was found between TRE and target localization error (TLE). Most of the predictions of the application accuracy (TRE) fall in the 68% confidence interval of the measured TTE. For the numerically simulated data, a prediction of TTE was not possible; TRE and TTE show a negligible correlation. CONCLUSION: Experimental application accuracy of computer-assisted navigation could be predicted satisfactorily with adequate models in an experimental setup with paired-point registration of CT images to a patient. The experimental findings suggest that it is possible to run navigation and prediction of navigation application accuracy basically defined by the spatial resolution/precision of the 3D tracker used.
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