title: Navigation of a robot-integrated fluorescence laparoscope in preoperative SPECT/CT and intraoperative freehand SPECT imaging data: a phantom study.
abstract: Robot-assisted laparoscopic surgery is becoming an established technique for prostatectomy and is increasingly being explored for other types of cancer. Linking intraoperative imaging techniques, such as fluorescence guidance, with the three-dimensional insights provided by preoperative imaging remains a challenge. Navigation technologies may provide a solution, especially when directly linked to both the robotic setup and the fluorescence laparoscope. We evaluated the feasibility of such a setup. Preoperative single-photon emission computed tomography/X-ray computed tomography (SPECT/CT) or intraoperative freehand SPECT (fhSPECT) scans were used to navigate an optically tracked robot-integrated fluorescence laparoscope via an augmented reality overlay in the laparoscopic video feed. The navigation accuracy was evaluated in soft tissue phantoms, followed by studies in a human-like torso phantom. Navigation accuracies found for SPECT/CT-based navigation were 2.25 mm (coronal) and 2.08 mm (sagittal). For fhSPECT-based navigation, these were 1.92 mm (coronal) and 2.83 mm (sagittal). All errors remained below the <1-cm detection limit for fluorescence imaging, allowing refinement of the navigation process using fluorescence findings. The phantom experiments performed suggest that SPECT-based navigation of the robot-integrated fluorescence laparoscope is feasible and may aid fluorescence-guided surgery procedures.
authors.affiliation: Leiden University Medical Center, Department of Surgery, Albinusdreef 2, Leiden 2333 ZA, The NetherlandsbLeiden University Medical Center, Department of Radiology, Interventional Molecular Imaging Laboratory, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
authors.forename: Matthias Nathanaël
authors.initials: MN
authors.lastname: van Oosterom
authors.affiliation: Leiden University Medical Center, Department of Radiology, Interventional Molecular Imaging Laboratory, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
authors.forename: Myrthe Adriana
authors.initials: MA
authors.lastname: Engelen
authors.affiliation: Leiden University Medical Center, Department of Radiology, Interventional Molecular Imaging Laboratory, Albinusdreef 2, Leiden 2333 ZA, The NetherlandscThe Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Department of Urology, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.
authors.forename: Nynke Sjoerdtje
authors.initials: NS
authors.lastname: van den Berg
authors.affiliation: Leiden University Medical Center, Department of Radiology, Interventional Molecular Imaging Laboratory, Albinusdreef 2, Leiden 2333 ZA, The NetherlandscThe Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Department of Urology, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.
authors.forename: Gijs Hendrik
authors.initials: GH
authors.lastname: KleinJan
authors.affiliation: The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Department of Urology, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.
authors.forename: Henk Gerrit
authors.initials: HG
authors.lastname: van der Poel
authors.affiliation: Technische Universität München, Computer Aided Medical Procedures, Institut für Informatik, I16, Boltzmannstr. 3, Garching bei München 85748, GermanyeSurgicEye GmbH, Friedenstraße 18A, München 81671, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wendler
authors.affiliation: Leiden University Medical Center, Department of Surgery, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
authors.forename: Cornelis Jan Hadde
authors.initials: CJ
authors.lastname: van de Velde
authors.affiliation: Technische Universität München, Computer Aided Medical Procedures, Institut für Informatik, I16, Boltzmannstr. 3, Garching bei München 85748, GermanyfJohns Hopkins University, Computer Aided Medical Procedures, 3400 North Charles Street, Hackerman 200, Baltimore, Maryland 21218, United States.
authors.forename: Nassir
authors.initials: N
authors.lastname: Navab
authors.affiliation: Leiden University Medical Center, Department of Radiology, Interventional Molecular Imaging Laboratory, Albinusdreef 2, Leiden 2333 ZA, The NetherlandscThe Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Department of Urology, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.
authors.forename: Fijs Willem Bernhard
authors.initials: FW
authors.lastname: van Leeuwen
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation*; D009369:Neoplasms / Q000000981:diagnostic imaging*; D012371:Robotics; D025321:Surgery, Computer-Assisted; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed