A region-based anatomical landmark configuration for sinus surgery using image guided navigation system: a phantom-study.
OBJECTIVE
To evaluate the current beliefs about the ways to reduce target registration error (TRE) values in image guided Sinus surgery by rearranging the fiducial configuration, and investigating the best configurations for various surgical fields in a phantom study.


METHODS
A new CT-compatible skull phantom consisting of implanted targets was designed to enable direct measurement of TRE in four fields of sinus surgery, Frontal, Ethmoid, Sphenoid and Maxillary. The effects of different landmark configurations on TRE values, measured by the Parsiss-IV navigation system were investigated to find the best landmark arrangement for each region, and compared to the TRE prediction formula to assess the clinically accepted landmark selection approaches based on this formula.


RESULTS
It was shown that smaller values of TRE could be attained by arranging the center of the fiducials to be more focused on the surgery target. The addition of more fiducials and keeping non-linear arrangement of landmark would not necessarily decrease the TRE value.


CONCLUSIONS
Optimizing the landmark configuration is important for increasing the localization accuracy in image guided sinus surgery. The common beliefs accepted in the clinical community about the ways to reduce the TRE are very general and should be adapted to specific field of image guided surgery.
Medical Physics and Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Iran; Research Center of Biomedical Technology and Robotics (RCBTR), Tehran University of Medical Sciences, Iran. Electronic address: ahmadian@tums.ac.ir.
Alireza
A
Ahmadian
Research Center of Biomedical Technology and Robotics (RCBTR), Tehran University of Medical Sciences, Iran.
Anahita
A
Fathi Kazerooni
Medical Physics and Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Iran.
Saeed
S
Mohagheghi
Medical Physics and Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Iran.
Keyvan
K
Amini Khoiy
Department of ENT of Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Moosa
M
Sadr Hosseini
D000465:Algorithms; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D004431:Ear, External / Q000000981:diagnostic imaging; D005005:Ethmoid Sinus / Q000000981:diagnostic imaging; D005143:Eyelids / Q000000981:diagnostic imaging; D057918:Fiducial Markers; D005626:Frontal Sinus / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D061330:Multidetector Computed Tomography / Q000379:methods; D009666:Nose / Q000000981:diagnostic imaging; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000601:surgery; D019047:Phantoms, Imaging; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted / Q000379:methods*
Fiducial point configuration; Fiducial registration; Image guided sinus surgery; Image guided surgery; Skull phantom; Target registration error