Integrated intraoperative imaging and navigation system for computer-assisted interventions

Medical images can help clinicians diagnose, monitor, and treat disease. Surgeons need intraoperative imaging and surgical navigation for accurate surgery. Fluorescence imaging is a rapidly emerging modality for image-guided surgery and therapy. Surgical navigation has been widely applied in neuro, spinal, cranial, and orthopedic surgeries. However, current surgical navigation systems have many challenges, including the need of fiducial markers, the lack of real-time registration update, and lack of functional imaging. A single imaging modality is oftentimes not optimal for anatomical and functional surgical guidance. Combination of different imaging modalities, in which strengths of individual techniques are consolidated, is an effective strategy to tackle this limitation. In clinical settings, intraoperative imaging and surgical navigation systems are usually separate and displayed on different monitors, resulting in difficulty to correlate different imageries and surgical field.

In this thesis, I have developed several versions of integrated intraoperative imaging and navigation systems for computer-assisted interventions. A novel Real-time Fluorescence Imaging Topography Scanning (RFITS) system was developed to deliver simultaneous real-time multimodal optical imaging, CT-to-Optical image registration, and dynamic fiducial-free surgical navigation. I applied the RFITS system in intraoperative fluorescence vascular angiography and tissue perfusion assessment with intuitive fluorescence/color images and 3D visualization. In addition, I have evaluated prospective clinical applications of the RFITS system for bone drilling guidance in orthopedic surgery and multimodal navigation in spine surgery. In another study, I developed an approach for 2D fluorescence-to-color image registration and built a wearable fluorescence imaging prototype for intraoperative augmented reality. The developed systems hold great potential to help surgeons perform accurate surgery and improve surgical outcomes.