Feasibility study for image-guided kidney surgery: assessment of required intraoperative surface for accurate physical to image space registrations.

A notable complication of applying current image-guided surgery techniques of soft tissue to kidney resections (nephrectomies) is the limited field of view of the intraoperative kidney surface. This limited view constrains the ability to obtain a sufficiently geometrically descriptive surface for accurate surface-based registrations. The authors examined the effects of the limited view by using two orientations of a kidney phantom to model typical laparoscopic and open partial nephrectomy views. Point-based registrations, using either rigidly attached markers or anatomical landmarks as fiducials, served as initial alignments for surface-based registrations. Laser range scanner (LRS) obtained surfaces were registered to the phantom's image surface using a rigid iterative closest point algorithm. Subsets of each orientation's LRS surface were used in a robustness test to determine which parts of the surface yield the most accurate registrations. Results suggest that obtaining accurate registrations is a function of the percentage of the total surface and of geometric surface properties, such as curvature. Approximately 28% of the total surface is required regardless of the location of that surface subset. However, that percentage decreases when the surface subset contains information from opposite ends of the surface and/or unique anatomical features, such as the renal artery and vein.