Evaluation of a portable image overlay projector for the visualisation of surgical navigation data: phantom studies

Presenting visual feedback for image-guided surgery on a monitor requires the surgeon to perform time-consuming comparisons and diversion of sight and attention away from the patient. Deficiencies in previously developed augmented reality systems for image-guided surgery have, however, prevented the general acceptance of any one technique as a viable alternative to monitor displays. This work presents an evaluation of the feasibility and versatility of a novel augmented reality approach for the visualisation of surgical planning and navigation data. The approach, which utilises a portable image overlay device, was evaluated during integration into existing surgical navigation systems and during application within simulated navigated surgery scenarios.

Projector-based augmented reality for intuitive intraoperative guidance in image-guided 3D interstitial brachytherapy

PURPOSE: The aim of this study is to implement augmented reality in real-time image-guided interstitial brachytherapy to allow an intuitive real-time intraoperative orientation. METHODS AND MATERIALS: The developed system consists of a common video projector, two high-resolution charge coupled device cameras, and an off-the-shelf notebook. The projector was used as a scanning device by projecting coded-light patterns to register the patient and superimpose the operating field with planning data and additional information in arbitrary colors. Subsequent movements of the nonfixed patient were detected by means of stereoscopically tracking passive markers attached to the patient. RESULTS: In a first clinical study, we evaluated the whole process chain from image acquisition to data projection and determined overall accuracy with 10 patients undergoing implantation. The described method enabled the surgeon to visualize planning data on top of any preoperatively segmented and triangulated surface (skin) with direct line of sight during the operation. Furthermore, the tracking system allowed dynamic adjustment of the data to the patient's current position and therefore eliminated the need for rigid fixation. Because of soft-part displacement, we obtained an average deviation of 1.1 mm by moving the patient, whereas changing the projector's position resulted in an average deviation of 0.9 mm. Mean deviation of all needles of an implant was 1.4 mm (range, 0.3-2.7 mm). CONCLUSIONS: The developed low-cost augmented-reality system proved to be accurate and feasible in interstitial brachytherapy. The system meets clinical demands and enables intuitive real-time intraoperative orientation and monitoring of needle implantation.

Holocene palaeoclimate and palaeovegetation on the islands of Flores and Pico

Palaeoclimatic stability is regarded as an important factor in explaining patterns of endemism in the Azorean flora. However, modelling simulations and quantitative reconstructions for the last 6000 years suggest considerable palaeoclimatic variability. Here we explore the link between Holocene palaeoclimate and palaeovegetation on the islands of Flores and Pico. Modern pollen assemblages indicate that most major plant communities can be detected using pollen analysis and that, in some cases, the pre-colonisation vegetation was quite similar to present-day relict vegetation. A 200–500-year pollen record from Alagoinha, a low-elevation mire in western Flores, shows that Juniperus brevifolia-dominated communities were widespread at lower elevations prior to large-scale deforestation. Today these communities are generally restricted to higher elevations. While our results are preliminary, there appears to be a weak link between palaeovegetation (which was primarily influenced by volcanism, soil formation and human impact) and palaeoclimatic changes detected through geochemical proxies. Even if the Azorean palaeoclimate varied substantially, its impact on the pristine vegetation, at least in terms of pollen production, was relatively small.