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. 2021 Sep 1;62(9):1314-1317.
doi: 10.2967/jnumed.120.259796. Epub 2021 Jan 8.

Optical Navigation of the Drop-In γ-Probe as a Means to Strengthen the Connection Between Robot-Assisted and Radioguided Surgery

Samaneh Azargoshasb  1 , Krijn H M Houwing  1 , Paul R Roos  1 , Sven I van Leeuwen  1 , Michael Boonekamp  2 , Elio Mazzone  3   4 , Kevin Bauwens  4 , Paolo Dell'Oglio  1   3   5   6 , Fijs W B van Leeuwen  1   4   6 , Matthias N van Oosterom  7   6
Affiliations

Optical Navigation of the Drop-In γ-Probe as a Means to Strengthen the Connection Between Robot-Assisted and Radioguided Surgery

Samaneh Azargoshasb et al. J Nucl Med. .

Abstract

With translation of the Drop-In γ-probe, radioguidance has advanced into laparoscopic robot-assisted surgery. Global-positioning-system-like navigation can further enhance the symbiosis between nuclear medicine and surgery. Therefore, we developed a fluorescence-video-based tracking method that integrates the Drop-In with navigated robotic surgery. Methods: Fluorescent markers, integrated into the Drop-In, were automatically detected using a daVinci Firefly laparoscope. Subsequently, a declipseSPECT-navigation platform calculated the Drop-In location within the surgical field. Using a phantom (n = 3), we pursued robotic navigation on SPECT/CT, whereas intraoperative feasibility was validated during porcine surgery (n = 4). Results: Video-based tracking allowed for navigation of the Drop-In toward all lesions detected on SPECT/CT (external iliac and common iliac artery regions). Augmented-reality visualization in the surgical console indicated the distance to these lesions in real time, confirmed by the Drop-In readout. Porcine surgery underlined the feasibility of the concept. Conclusion: Optical navigation of the Drop-In probe provides a next step toward connecting nuclear medicine with robotic surgery.

Keywords: augmented reality; image-guided surgery; optical navigation; radioguided surgery; robot-assisted surgery.

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Figures

None
Graphical abstract
FIGURE 1.
FIGURE 1.
Overview of Drop-In tracking-and-navigation setup displaying underlying pose relations with colored arrows, describing the relative positions and orientations of all objects in the navigation workflow. (A) Near-infrared optical tracking determines the pose of Firefly and patient reference targets (red arrows), whereas underlying registrations translate this pose to Firefly camera (purple arrow) and lesions as found on SPECT/CT (orange arrow). (B) Vision-based tracking from Firefly determines the pose of Drop-In markings within surgical field (blue arrow), and these markings are calibrated with Drop-In probe tip (purple arrow). Finally, the Drop-In can be navigated toward SPECT/CT-marked lesions. NAV = navigation system; RT = reference target; T = pose transformation.
FIGURE 2.
FIGURE 2.
Real-time Drop-In tracking and navigation during robot-assisted laparoscopic surgery on phantom. (A) Setup overview. (B) Phantom SPECT/CT example, displaying patient reference target (PRT) and targeted lymph node (SN). (C) Augmented-reality visualization in surgical console, displaying Drop-In navigation toward lymph node (including calculated distance).
FIGURE 3.
FIGURE 3.
Real-time tracking of Drop-In probe with respect to targeted lesions during robot-assisted laparoscopic surgery on pig. (A) Operating room overview. (B) White-light image. (C–E) Tracking of Drop-In probe with respect to targeted lesion (pink) using fluorescence imaging at calculated target distances of 79, 34, and 3 mm.
See this image and copyright information in PMC

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