Enhanced Reality Visualization in a Surgical Environment

Enhanced reality visualization is the process of enhancing an image by adding to it information which is not present in the original image. A wide variety of information can be added to an image ranging from hidden lines or surfaces to textual or iconic data about a particular part of the image. Enhanced reality visualization is particularly well suited to neurosurgery. By rendering brain structures which are not visible, at the correct location in an image of a patient's head, the surgeon is essentially provided with X-ray vision. He can visualize the spatial relationship between brain structures before he performs a craniotomy and during the surgery he can see what's under the next layer before he cuts through. Given a video image of the patient and a three dimensional model of the patient's brain the problem enhanced reality visualization faces is to render the model from the correct viewpoint and overlay it on the original image. The relationship between the coordinate frames of the patient, the patient's internal anatomy scans and the image plane of the camera observing the patient must be established. This problem is closely related to the camera calibration problem. This report presents a new approach to finding this relationship and develops a system for performing enhanced reality visualization in a surgical environment. Immediately prior to surgery a few circular fiducials are placed near the surgical site. An initial registration of video and internal data is performed using a laser scanner. Following this, our method is fully automatic, runs in nearly real-time, is accurate to within a pixel, allows both patient and camera motion, automatically corrects for changes to the internal camera parameters (focal length, focus, aperture, etc.) and requires only a single image.

Segmentation of Brain Tissue from Magnetic Resonance Images

Segmentation of medical imagery is a challenging problem due to the complexity of the images, as well as to the absence of models of the anatomy that fully capture the possible deformations in each structure. Brain tissue is a particularly complex structure, and its segmentation is an important step for studies in temporal change detection of morphology, as well as for 3D visualization in surgical planning. In this paper, we present a method for segmentation of brain tissue from magnetic resonance images that is a combination of three existing techniques from the Computer Vision literature: EM segmentation, binary morphology, and active contour models. Each of these techniques has been customized for the problem of brain tissue segmentation in a way that the resultant method is more robust than its components. Finally, we present the results of a parallel implementation of this method on IBM's supercomputer Power Visualization System for a database of 20 brain scans each with 256x256x124 voxels and validate those against segmentations generated by neuroanatomy experts.

Compact Representations for Fast Nonrigid Registration of Medical Images

We develop efficient techniques for the non-rigid registration of medical images by using representations that adapt to the anatomy found in such images. Images of anatomical structures typically have uniform intensity interiors and smooth boundaries. We create methods to represent such regions compactly using tetrahedra. Unlike voxel-based representations, tetrahedra can accurately describe the expected smooth surfaces of medical objects. Furthermore, the interior of such objects can be represented using a small number of tetrahedra. Rather than describing a medical object using tens of thousands of voxels, our representations generally contain only a few thousand elements. Tetrahedra facilitate the creation of efficient non-rigid registration algorithms based on finite element methods (FEM). We create a fast, FEM-based method to non-rigidly register segmented anatomical structures from two subjects. Using our compact tetrahedral representations, this method generally requires less than one minute of processing time on a desktop PC. We also create a novel method for the non-rigid registration of gray scale images. To facilitate a fast method, we create a tetrahedral representation of a displacement field that automatically adapts to both the anatomy in an image and to the displacement field. The resulting algorithm has a computational cost that is dominated by the number of nodes in the mesh (about 10,000), rather than the number of voxels in an image (nearly 10,000,000). For many non-rigid registration problems, we can find a transformation from one image to another in five minutes. This speed is important as it allows use of the algorithm during surgery. We apply our algorithms to find correlations between the shape of anatomical structures and the presence of schizophrenia. We show that a study based on our representations outperforms studies based on other representations. We also use the results of our non-rigid registration algorithm as the basis of a segmentation algorithm. That algorithm also outperforms other methods in our tests, producing smoother segmentations and more accurately reproducing manual segmentations.