Samaneh Azargoshasb1, Krijn H M Houwing1, Paul R Roos1, Sven I van Leeuwen1, Michael Boonekamp2, Elio Mazzone3,4, Kevin Bauwens4, Paolo Dell'Oglio1,3,5,6, Fijs W B van Leeuwen1,4,6, Matthias N van Oosterom7,6. 1. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. 2. Instrumentele Zaken Ontwikkeling, Facilitair Bedrijf, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute IRCCS San Raffaele Scientific Institute, Milan, Italy. 4. Orsi Academy, Melle, Belgium. 5. Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; and. 6. Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 7. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; m.n.van_oosterom@lumc.nl.
Abstract
With translation of the Drop-In γ-probe, radioguidance has advanced into laparoscopic robot-assisted surgery. Global-positioning-system-like navigation can further enhance the symbiosis between nuclear medicine and surgery. Therefore, we developed a fluorescence-video-based tracking method that integrates the Drop-In with navigated robotic surgery. Methods: Fluorescent markers, integrated into the Drop-In, were automatically detected using a daVinci Firefly laparoscope. Subsequently, a declipseSPECT-navigation platform calculated the Drop-In location within the surgical field. Using a phantom (n = 3), we pursued robotic navigation on SPECT/CT, whereas intraoperative feasibility was validated during porcine surgery (n = 4). Results: Video-based tracking allowed for navigation of the Drop-In toward all lesions detected on SPECT/CT (external iliac and common iliac artery regions). Augmented-reality visualization in the surgical console indicated the distance to these lesions in real time, confirmed by the Drop-In readout. Porcine surgery underlined the feasibility of the concept. Conclusion: Optical navigation of the Drop-In probe provides a next step toward connecting nuclear medicine with robotic surgery.
With translation of the Drop-In γ-probe, radioguidance has advanced into laparoscopic robot-assisted surgery. Global-positioning-system-like navigation can further enhance the symbiosis between nuclear medicine and surgery. Therefore, we developed a fluorescence-video-based tracking method that integrates the Drop-In with navigated robotic surgery. Methods: Fluorescent markers, integrated into the Drop-In, were automatically detected using a daVinci Firefly laparoscope. Subsequently, a declipseSPECT-navigation platform calculated the Drop-In location within the surgical field. Using a phantom (n = 3), we pursued robotic navigation on SPECT/CT, whereas intraoperative feasibility was validated during porcine surgery (n = 4). Results: Video-based tracking allowed for navigation of the Drop-In toward all lesions detected on SPECT/CT (external iliac and common iliac artery regions). Augmented-reality visualization in the surgical console indicated the distance to these lesions in real time, confirmed by the Drop-In readout. Porcine surgery underlined the feasibility of the concept. Conclusion: Optical navigation of the Drop-In probe provides a next step toward connecting nuclear medicine with robotic surgery.
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