Registration using 3D-printed rigid templates outperforms manually scanned surface matching in image-guided temporal bone surgery.
OBJECTIVE
Image-guided surgery (IGS) for otological procedures requires minimal invasiveness and a high degree of accuracy. We have recently developed a noninvasive registration method, the Surface Template-Assisted Marker Positioning (STAMP) method, which uses a rigid template of the surface of the temporal bone. However, the STAMP method is not applicable when the bony surface is not exposed, such as in endoscopic surgery. Thus, we extended our research to apply the STAMP method onto the skin and tested its feasibility in this study.


METHODS
We designed a phantom made of a rigid box and soft material for the study. The target registration error (TRE) was measured at preset measuring points in the phantom. We modified the STAMP method to be applicable for use on the skin around the ears (S-STAMP). The same phantom was also registered using the conventional, manually scanned surface matching method. We compared the TRE after the different registration methods.


RESULTS
The TRE after the S-STAMP registration method was significantly smaller than that of the conventional surface matching method at all error measurement points in the phantom. However, the TRE after the S-STAMP registration method was significantly larger than that of paired point registration using invasive fiducial markers.


CONCLUSIONS
The S-STAMP method using a rigid template on the soft surface yields a significantly smaller TRE than that of conventional, manually scanned surface matching registration. This strategy provides an alternative option to improve the accuracy of IGS without loading patients with additional invasive procedures.
Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Makoto
M
Yamashita
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan. matunozo@med.kyushu-u.ac.jp.
Nozomu
http://orcid.org/0000-0003-0799-6704
N
Matsumoto
Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Byunghyun
B
Cho
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
Noritaka
N
Komune
Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan.
Shinya
S
Onogi
Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jongseung
J
Lee
Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan.
Jordan
J
Bano
Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Tomohiko
T
Akahoshi
Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Makoto
M
Hashizume
D000465:Algorithms; D004427:Ear Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D057918:Fiducial Markers; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures; D019047:Phantoms, Imaging; D025321:Surgery, Computer-Assisted / Q000379:methods; D013701:Temporal Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods
Image-guided surgery; Otology; Registration; Surgical navigation; Transcanal endoscopic ear surgery