Image-guided neurosurgery : integration of medical image data with real-time view of the surgical field

This thesis presents the development of an image-guided neurosurgery system designed to track a video camera as it moves in space over the immobile head of a patient, and to project graphical representations of surgical targets on live video from the perspective of the camera. System development is motivated by clinical experience using Radionics, Incorporated image-guided neurosurgical systems at Massachusetts General Hospital (MGH). Radionics contributions include system hardware, an image pre-processor, and communications software incorporated with video system software. The MGH Center for Procedural Medicine and MGH Neurosurgical Services provided funds and guidance. System errors are analyzed and combined to produce an estimate for error in placing a graphic over video. System software is presented: a preoperative planning tool for extracting graphics from magnetic resonance (MR) or computerized tomography (CT) images, and an intraoperative application to produce the augmented reality scene on a display near a surgeon. Preplanning software is available for use. Intraoperative software requires integration with computer video hardware. When complete, the graphic-on-video system will allow MGH Neurosurgical Services to investigate the clinical merit of augmented reality displays for neurosurgical navigation. Thesis Supervisor: Thomas B. Sheridan Title: Professor of Engineering and Applied Psychology Professor of Aeronautics and Astronautics Acknowledgements This work was made possible through the generous contributions of the Warren M. Rohsenow Graduate Fellowship administered by the MIT Mechanical Engineering Department, The Center for Procedural Medicine at the Massachusetts General Hospital (MGH), and Radionics, Incorporated (Burlington, MA). William E. Butler, M.D., and G. Rees Cosgrove, M.D., both in Neurosurgical Services at MGH supplied vision for this work. I thank them for giving me an opportunity to work in an incredibly rewarding, high-technology field. Additionally, this project was made possible through the guidance and support of Eric R. Cosman, Professor Emeritus, Department of Physics, Massachusetts Institute of Technology, and President of Radionics. I thank Dr. Cosman for giving me full access to Radionics facilities, and for motivating me with his insight. A wonderful team of Radionics employees assisted my work. Computing expertise and manufacturing facilities were offered regularly. I appreciate the time many people committed to helping me learn. I would have made minimal progress without the assistance of Radionics employees. The MIT Human-Machine Systems Laboratory, directed by Professor Tom Sheridan, provided computer resources required for generating and simulating design ideas. I am grateful for Professor Sheridan's support of a project that continually changed scope. I thank Mark Ottensmeyer for helping me get started, and the entire Human-Machine Systems Lab for making my MIT experience an enjoyable one. My fiancee Kris has been a loving supporter throughout this project. Thank you, Kris. My parents, my sister and her family, my grandparents, friends, and teachers have always encouraged and motivated me. For them I am truly grateful. Table of