Image-Guided Interventions Terry Peters • Kevin Cleary Editors

Image-Guided Interventions

Technology and Applications Editors Terry Peters Kevin Cleary Imaging Research Laboratories Radiology Department Robarts Research Institute Imaging Science and Information University of Western Ontario Systems (ISIS) Center 100 Perth Drive 2115 Wisconsin Ave. NW, Suite 603 London, ON N6A 5K8 Washington, DC 20057 Canada USA

ISBN: 978-0-387-73856-7 e-ISBN: 978-0-387-73858-1

Library of Congress Control Number: 2007943573

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We would like to express our deepest gratitude to our colleague Jackie C. Williams, MA, for taking on the burden of Executive Editor of this book, for haranguing the authors, ensuring the manuscripts were delivered in time, editing them to perfection, and moulding them into the consistent format of the book. Without Jackie’s dedicated involvement and professional skills, the production of this book could not have moved forward!

Foreword

Technical and clinical developments in the field of image-guided interventions have reached a stage **which makes the appearance of this book particularly timely. The chapters are by leading researchers, many of whom have been important contributors to the International Conference series Medical Image Computing and Computer Assisted Interventions (MICCAI). The chapters provide excellent reviews that will be useful to a range of readers. While the material will generally be most accessible to those with a technical background (engineers, computer scientists, and physicists), books like this are increasingly important for clinical practitioners (surgeons and other interventionists) as well as clinical researchers and students with a background in medicine or biology. The field is emphatically cross- disciplinary, and close cooperation between the medical and the technical experts is critical. Constant preoccupation with high-volume patient throughput often inhibits the participation of highly trained clinicians in technically challenging research and well-written sources such as this volume, which can be used by clinicians as well as scientists, make a real contribution. During interventions where images provide guidance, the effector may of course be the hand of the surgeon, but there are many exciting developments involving remote effectors where the surgeon is distanced from the final actions. Partially autonomous robotic systems, for example, in orthopaedic surgery (Chap. 12), allow much improved reliability for certain procedures. Micromanipulators potentially allow finer-scale interventions that are increasing in importance, particularly when the effector is at the end of an endoscope. In the future, we will also see the use of effectors with no mechanical link to the outside world, and such devices have the potential to function at a microscopic scale. The strength of this book is to include radiation therapy as one of the effectors (Chaps. 16 and 17). The engineers involved in the design of all types of effectors including robots and remotely controlled devices need to remain fully engaged with image computing and clinical research in this cross-disciplinary field: whole-system integration is the key to future success. This remains a strong part of the philosophy of the MICCAI conferences.

vii viii Foreword What are the key areas which determine progress and future directions? This book provides several pointers. An important limitation of image guidance arises when images acquired earlier become out-of-date before a procedure is completed, because of physiological or pathological changes in the tissue and especially because of changes brought about by the intervention itself. Some developments in intra-operative imaging that provide regularly updated imaging are covered in the book (including MRI in Chaps. 10 and 14, and ultrasound in Chap. 15), and we look forward to further significant advances in these and other modalities. Developments in modelling of tissue deformations and in non-rigid registration (Chap. 7) continue to be important. This has particular relevance for thoracoabdominal interventions (Chap. 13). Evaluating the benefits and risks of image-guided interventions is of central importance (Chap. 18 and passim). Benefits for certain procedures has now been demonstrated in many clinical specialities. However, making the procedures available to patients in routine practice faces the huge hurdle of persuading healthcare funders of the cost-effectiveness of procedures. As healthcare costs generally increase, demonstrating improvements in the quality of care is not enough to secure support for clinical use, but quantifying benefit in economic terms, beloved by many health economists, is a very inexact process and often open to a wide range of interpretations. It is likely that in the short term image-guided systems will continue to make inroads into clinical practice only for isolated applications. Researchers need to continue to work very hard to generate quantitative and qualitative validation data. In some countries and clinical specialties, there is at present often great reluctance of funders and managers to support the introduction of new technology. But as patients and the public perception of the nature of the improvements provided by image-guided interventions continues to rise, demand will increase to a level which will greatly facilitate subsequent developments.

Alan Colchester

Professor of Clinical Neuroscience and Medical Image Computing, University of Kent, Canterbury, England

Consultant Neurologist, Guy’s & St. Thomas’s Hospitals, London and East Kent Hospitals Trust

Medical Image Computing and Computer-Assisted Intervention Board Chairman 1999–2007 and Society President 2004–2007 Preface

This book had its genesis in 2003, when Dr. Lixu Gu of Shanghai Jiatong University asked whether we would consider organizing a workshop on image- guided interventions at the 2005 International Symposium on Engineering in Medicine and Biology in Shanghai, China. We agreed and our subsequent workshop included five individual speakers and covered neurological, orthopedic, and abdominal applications of image-guided interventions, with the inclusion of issues on visualization and image processing. After the symposium, Springer-Verlag approached us about editing a book on the basis of the workshop, and we decided that such a book would indeed fill a niche in the literature, but to do its justice, it would need to cover more than the original five topics. We asked Jackie Williams to take on the role of Executive Editor, and over the next six months, we received agreement from the authors represented in this book, which includes 18 chapters divided between principles and applications. The title, “Image-Guided Interventions” was deliberately chosen over “Image-Guided Surgery” or “Minimally-Invasive Surgery and Therapy,” as it covers the widest range of both therapeutic and surgical procedures, and reflects the recognition that the basic principles covered in the first part of the book are applicable to all such procedures. In addition, the inclusion of two chapters dealing with radiation-based therapies recognizes the convergence between surgery and radiation therapy in terms of the guidance technologies. This book is aimed at both the graduate student embarking on a career in medical imaging, and the practicing researcher or clinician who needs a snapshot of the state-of-the-art in both the principles and practice of this discipline. Accordingly, the book begins with a historical overview of the development of image guidance for medical procedures, and follows with discussions of the critical components of tracking technologies, visualization, augmented reality, image registration (both rigid and nonrigid) image segmentation, and image acquisition. A chapter on the important issue of software development for image-guided systems is also included, as is one on the equally important issue of validation. In the application section, examples are presented on the use of image guidance for focused ultrasound therapy, neurosurgery, orthopedics, abdominal surgery, prostate therapy, and cardiac applications. Finally, the linkages between image-guided surgery and radiation therapy are highlighted in chapters on the clinical application of radiosurgery and radiation oncology.

ix x Preface

We sincerely thank our colleagues for agreeing to assist us in this endeavor, and for putting up with our incessant demands over the past year.

Terry Peters London, ON, Canada

Kevin Cleary Washington, DC, USA

November 2007

Contents

Foreword ...... vii

Preface ...... ix

Contributors ...... xxiii

List of Abbreviations ...... xxix

1. Overview and History of Image-Guided Interventions ...... 1 Robert Galloway and Terry Peters 1.1 Introduction...... 1 1.2 Stereotaxy ...... 2 1.3 The Arrival of Computed Tomography ...... 6 1.3.1 Computer Systems Come of Age ...... 7 1.4 Image-Guided Surgery...... 8 1.5 Three-Dimensional Localization ...... 9 1.5.1 Handheld Localizers...... 10 1.6 Registration Techniques...... 12 1.7 Display ...... 14 1.8 The Next Generation of Systems ...... 15 References ...... 16

2. Tracking Devices ...... 23 Wolfgang Birkfellner, Johann Hummel, Emmanuel Wilson, and Kevin Cleary 2.1 Introduction...... 23 2.2 Tracking: A Brief History...... 24 2.3 Principles of Optical Tracking Systems...... 27 2.4 Principles of Electromagnetic Tracking...... 28 2.5 Other Technologies...... 31 2.6 Data Transmission and Representation...... 34

xi xii Contents

2.7 Accuracy ...... 35 2.8 Conclusions...... 35 References ...... 36

3. Visualization in Image-Guided Interventions...... 45 David Holmes III, Maryam Rettmann, and Richard Robb 3.1 Introduction...... 45 3.2 Coordinate Systems ...... 46 3.3 Preoperative Images...... 47 3.3.1 Computed Tomography...... 48 3.3.2 Magnetic Resonance Imaging ...... 49 3.3.3 Nuclear Image Scans and Other Functional Data ...... 50 3.4 Intraoperative Data...... 51 3.4.1 X-Ray Fluoroscopy and Rotational Angiography...... 51 3.4.2 Intraoperative Ultrasound...... 52 3.4.3 Intraoperative CT and Intraoperative MR...... 53 3.5 Integration...... 53 3.5.1 Segmentation and Surface Extraction ...... 53 3.5.2 Registration ...... 54 3.6 Visualization ...... 55 3.6.1 2D – Multi-Planar and Oblique...... 55 3.6.2 3D Surface Rendering and 3D Volume Rendering.....57 3.6.3 Fusion, Parametric Mapping, and Multi-Object Rendering ...... 59 3.7 Systems for Visualization...... 61 3.7.1 Low-Level Interfacing to Hardware...... 61 3.7.2 Pipeline-Based APIs...... 62 3.7.3 Scene-Graph APIs...... 62 3.7.4 Software Rendering APIs...... 63 3.7.5 Numerical Computing with Visualization...... 65 3.8 Real-Time Feedback and Hardware Interfacing...... 65 3.8.1 Receiving Input...... 65 3.8.2 Presenting Output...... 67 3.9 Applications ...... 67 3.9.1 Epilepsy Foci Removal ...... 67 3.9.2 Left Atrium Cardiac Ablation...... 68 3.9.3 Permanent Prostate Brachytherapy ...... 70 3.9.4 Virtual and Enhanced Colonoscopy...... 72 3.9.5 Surgical Separation of Conjoined Twins...... 73 3.10 Summary...... 75 References ...... 76

Contents xiii

4. Augmented Reality...... 81 Frank Sauer, Sebastian Vogt, and Ali Khamene 4.1 Introduction...... 81 4.1.1 What Is Augmented Reality? ...... 81 4.1.2 Why AR for Interventional Guidance? ...... 83 4.2 Technology Building Blocks and System Options ...... 84 4.3 System Examples and Applications ...... 85 4.3.1 Optical Microscope Systems...... 85 4.3.2 Video AR Systems...... 88 4.3.3 Large Screens...... 91 4.3.4 Tomographic Overlays...... 97 4.3.5 Video Enodoscope Systems ...... 102 4.3.6 Other Methods: Direct Projection ...... 104 4.4 System Features Overview ...... 104 4.4.1 Microscope Systems...... 104 4.4.2 Video AR HMD Systems...... 105 4.4.3 Semitransparent Screens...... 105 4.4.4 Tomographic Displays...... 106 4.4.5 Optical See-Through HMD Systems...... 106 4.5 Technical Challenges and Fundamental Comparisons ...... 107 4.5.1 Right Place: Calibration...... 107 4.5.2 Right Time: Synchronization ...... 107 4.5.3 Right Way: Visualization and Perception ...... 108 4.6 Concluding Remarks and Outlook...... 110 References ...... 111

5. Software...... 121 Luis Ibánez 5.1 Introduction...... 121 5.1.1 The Need for Software...... 121 5.1.2 Software as a Risk Factor...... 122 5.1.3 Quality Control...... 123 5.1.4 The Cost of Software Maintenance...... 123 5.1.5 Open Source Versus Closed Source...... 124 5.2 Software Development Process ...... 127 5.2.1 FDA Guidelines...... 128 5.2.2 Requirements...... 130 5.2.3 Validation and Verification...... 131 5.2.4 Testing...... 131 5.2.5 Bug Tracking...... 138 xiv Contents

5.2.6 Coding Style...... 139 5.2.7 Documentation ...... 140 5.2.8 Refactoring ...... 141 5.2.9 Backward Compatibility Versus Evolution...... 142 5.3 Design ...... 143 5.3.1 Safety by Design...... 143 5.3.2 Architecture...... 144 5.3.3 User Interaction...... 145 5.3.4 Keeping It Simple...... 146 5.3.5 Risk Analysis...... 147 5.3.6 State Machines...... 148 5.3.7 Devices ...... 154 5.3.8 Realism Versus Informative Display ...... 156 References ...... 156

6. Rigid Registration ...... 159 Ziv Yaniv 6.1 Introduction...... 159 6.2 3D/ 3D Registration...... 160 6.2.1 Geometry-Based Methods...... 161 6.2.2 Intensity-Based Methods...... 167 6.3 2D/3D Registration...... 172 6.3.1 Geometry-Based Methods...... 175 6.3.2 Intensity-Based Methods...... 178 6.3.3 Gradient-Based Methods...... 181 6.4 Registration Evaluation...... 183 6.5 Conclusions...... 186 References ...... 187

7. Nonrigid Registration ...... 193 David Hawkes, Dean Barratt, Tim Carter, Jamie McClelland, and Bill Crum 7.1 Introduction...... 193 7.2 NonRigid Registration Technologies Potentially Applicable to Image-Guided Interventions...... 196 7.2.1 Feature-Based Algorithms...... 197 7.2.2 Intensity-Based Algorithms...... 198 7.2.3 Optimization...... 199 7.2.4 Nonrigid 2D-3D Registration...... 199 7.2.5 Incorporation of Biomechanical Models...... 200 Contents xv

7.2.6 Statistical Shape Models...... 201 7.2.7 Real-Time Requirements...... 201 7.3 Validation...... 202 7.4 Applications of Image-Guided Applications to Soft Deforming Tissue ...... 203 7.4.1 Locally Rigid Transformations ...... 203 7.4.2 Biomechanical Models...... 203 7.4.3 Motion Models...... 206 7.4.4 Application of Statistical Shape Models ...... 211 7.5 Conclusion ...... 213 References ...... 214

8. Model-Based Image Segmentation for Image-Guided Interventions ...... 219 Wiro Niessen 8.1 Introduction...... 219 8.2 Low-Level Image Segmentation...... 220 8.3 Model-Based Image Segmentation...... 222 8.3.1 Introduction ...... 222 8.3.2 Classical Parametric Deformable Models or Snakes ...... 223 8.3.3 Level Set Segmentation...... 224 8.3.4 Statistical Shape Models...... 228 8.4 Applications ...... 232 8.4.1 Segmentation in Image-Guided Interventions...... 232 8.5 Future Directions...... 234 References ...... 235

9. Imaging Modalities...... 241 Kenneth H. Wong 9.1 Introduction...... 241 9.2 X-Ray Fluoroscopy and CT...... 242 9.2.1 Basic Physics Concepts...... 242 9.2.2 Fluoroscopy...... 244 9.2.3 Computed Tomography...... 247 9.2.4 Current Research and Development Areas ...... 250 9.3 Nuclear Medicine...... 251 9.3.1 Basic Physics Concepts...... 251 9.3.2 Positron Emission Tomography ...... 252 9.3.3 Single Photon Emission Tomography...... 254 xvi Contents 9.3.4 Patient Access and Work Environment...... 256 9.3.5 Current Research and Development Areas ...... 256 9.4 Magnetic Resonance Imaging...... 257 9.4.1 Basic Physics Concepts...... 257 9.4.2 System Components...... 258 9.4.3 Image Characteristics...... 259 9.4.4 Patient Access and Work Environment...... 259 9.4.5 Current Research and Development Areas ...... 260 9.5 Ultrasound...... 262 9.5.1 Basic Physics Concepts...... 262 9.5.2 System Components...... 263 9.5.3 Image Characteristics...... 264 9.5.4 Patient Access and Work Environment...... 265 9.5.5 Current Research and Development Areas ...... 265 9.6 Summary and Discussion...... 268 References ...... 270

10. MRI-Guided FUS and its Clinical Applications...... 275 Ferenc Jolesz, Nathan McDannold, Greg Clement, Manabu Kinoshita, Fiona Fennessy, and Clare Tempany 10.1 Introduction ...... 275 10.2 MRgFUS Technology...... 276 10.2.1 Acoustic Components...... 279 10.2.2 Closed-Loop Control...... 281 10.3 Planning and Execution...... 284 10.4 The Commercial Therapy Delivery System...... 285 10.5 Clinical Applications...... 289 10.5.1 Commercial Brain Treatment System: ExAblate...... 291 10.6 Targeted Drug Delivery and Gene Therapy ...... 292 10.6.1 BBB Disruption...... 293 10.7 Conclusion...... 297 References ...... 297

11. Neurosurgical Applications ...... 309 Terry Peters, Kirk Finnis, Ting Guo, and Andrew Parrent 11.1 Introduction ...... 309 11.2 Stereotactic Neurosurgery...... 309 11.3 Atlases ...... 311 11.4 Intraoperative Electrophysiological Confirmation...... 312 Contents xvii

11.5 Electrophysiological Databases...... 313 11.6 Standard Brain Space ...... 314 11.7 Image Registration...... 315 11.8 Surgical Targets...... 316 11.8.1 Standardizing Electrophysiological Data in Patient Native MRI-Space ...... 317 11.8.2 Application to Deep-Brain Neurosurgery ...... 318 11.8.3 Representative Database Searches ...... 318 11.8.4 Target Prediction Using EP Atlases ...... 321 11.9 Integration of the Neurosurgical Visualization and Navigation System...... 321 11.9.1 Digitized Brain Atlas and Segmented Deep-Brain Nuclei...... 322 11.9.2 Final Surgical Target Locations ...... 322 11.9.3 Surgical Instrument Representation ...... 322 11.9.4 Visualization and Navigation Platform ...... 322 11.10 System Validation...... 324 11.10.1 Conventional Planning Approach ...... 324 11.10.2 System-Based Planning Procedure ...... 324 11.11 Discussion ...... 328 References ...... 329

12. Computer-Assisted Orthopedic Surgery...... 333 Antony Hodgson 12.1 Introduction ...... 333 12.2 Orthopedic Practice...... 336 12.2.1 Clinical Practice of Orthopedics...... 336 12.2.2 CAOS Procedures...... 337 12.2.3 Review of Quantitative Technologies Used in Orthopedics...... 338 12.3 Evaluation...... 339 12.3.1 Improved Technical and Functional Outcomes...339 12.3.2 Reduced Operative Times ...... 342 12.3.3 Reduced Costs...... 342 12.3.4 Other Issues Affecting Adoption...... 343 12.3.5 Prospective Randomized Clinical Trials ...... 344 12.4 Practice Areas...... 346 12.4.1 Hip Replacement...... 346 12.4.2 Knee Replacement...... 357 12.4.3 Pedicle Screw Insertion ...... 366 xviii Contents

12.4.4 Fracture Repair...... 370 12.5 Summary and Future Trends ...... 375 References...... 376

13. Thoracoabdominal Interventions ...... 387 Filip Banovac, Jill Bruno, Jason Wright, and Kevin Cleary 13.1 Introduction ...... 387 13.2 Lung: Bronchoscopic Biopsy ...... 389 13.2.1 Beginings of Guided Bronchoscopy: Biosense...... 389 13.2.2 Clinical Evolution: SuperDimension...... 392 13.2.3 Aurora-Based System ...... 393 13.3 Liver ...... 393 13.3.1 Transjugular Intrahepatic Shunt Placement (TIPS)...... 394 13.3.2 Biopsy and Thermoablatio.n ...... 396 13.3.3 Image-Guided Liver Surgery...... 399 13.4 Kidney: Ultrasound-Guided Nephrostomy ...... 401 13.5 Laparoscopic Guidance...... 403 13.5.1 Phantom Investigations...... 404 13.5.2 Swine Studies...... 404 13.6 Summary and Research Issues ...... 405 References...... 406

14. Real-Time Interactive MRI for Guiding Cardiovascular Surgical Interventions...... 409 Michael Guttman, Keith Horvath, Robert Lederman, and Elliot McVeigh 14.1 Introduction ...... 409 14.2 Interventional MR Imaging System ...... 411 14.2.1 Magnet Configuration...... 411 14.2.2 Interventional Imaging Platform ...... 411 14.2.3 Pulse Sequences and Image Reconstruction...... 412 14.2.4 Interactive Imaging Features ...... 413 14.2.5 Invasive Devices and Experiments...... 416 14.2.6 Room Setup...... 417 14.3 Initial Preclinical Procedures...... 418 14.4 Discussion ...... 422 References...... 424

Contents xix

15. Three-Dimensional Ultrasound Guidance and Robot Assistance for Prostate Brachytherapy...... 429 Zhouping Wei, Lori Gardi, Chandima Edirisinghe, Dónal Downey, and Aaron Fenster 15.1 Introduction ...... 429 15.1.1 Prostate Brachytherapy...... 431 15.1.2 Limitations of Current Brachytherapy...... 433 15.1.3 Potential Solutions...... 433 15.2 System Description...... 434 15.2.1 Hardware Components...... 434 15.2.2 System Calibration...... 436 15.2.3 Software Tools...... 438 15.3 System Evaluation...... 445 15.3.1 Evaluation of Calibration ...... 445 15.3.2 Needle Positioning and Orientation Accuracy by Robot ...... 449 15.3.3 Needle Targeting Accuracy...... 450 15.3.4 Evaluation of the Prostate Segmentation Algorithm ...... 452 15.3.5 Evaluation of the Needle Segmentation Algorithm ...... 454 15.3.6 Evaluation of the Seed Segmentation Algorithm ...... 455 15.4 Discussion ...... 457 References...... 458

16. Radiosurgery...... 461 Sonja Dieterich, James Rodgers, and Rosanna Chan 16.1 Introduction ...... 461 16.1.1 Definition of Radiosurgery...... 461 16.1.2 Review of Body Sites Treated with Radiosurgery...... 462 16.1.3 What is Image-Guided Radiosurgery (IGRT)? ...463 16.2 Gamma Knife ® ...... 464 16.2.1 History ...... 468 16.2.2 Current Status...... 471 16.2.3 Developments ...... 475 16.3 Conventional Linac-Based Radiosurgery Systems ...... 477 16.3.1 Frame-Based Systems...... 478 16.3.2 Image-Guided Setup Systems...... 480 xx Contents 16.3.3 Image-Guided Treatment with Respiratory Motion...... 481 16.4 Image-Guided Robotic Radiosurgery...... 481 16.4.1 History and Description of the CyberKnife...... 481 16.4.2 Frameless Tracking Technology for Cranial Surgery, Spine, and Body...... 482 16.4.3 Treatment Planning...... 490 16.4.4 Treatment Delivery...... 491 16.4.5 Four-Dimensional Real-Time Adaptive Respiratory Tracking (Synchrony) Technology..491 16.5 Future of Image-Guided Radiosurgery...... 494 16.5.1 Future Tracking Technologies...... 494 16.5.2 Treatment Planning Algorithms ...... 497 16.6 Summary ...... 497 References...... 497

17. Radiation Oncology...... 501 David Jaffray, Jeffrey Siewerdsen, and Mary Gospodarowicz 17.1 Introduction ...... 501 17.2 Oncological Targets and the Nature of Disease Management...... 502 17.3 Imaging and Feedback in Intervention...... 503 17.3.1 Formalisms for Execution of Therapy...... 503 17.3.2 Dimensions of an Image-Guided Solution for Radiation Therapy ...... 504 17.3.3 Image Guidance Technologies in Radiation Oncology ...... 506 17.4 Image-Guided Applications in Radiation Oncology...... 514 17.4.1 Prostate Cancer: Off-Line and Online Models....514 17.4.2 Stereotactic Body Radiation Therapy (SBRT) for Cancer of the Lung...... 515 17.4.3 Accelerated Partial Breast Irradiation ...... 517 17.5 Image Guidance Approaches that Bridge Therapeutic Modalities...... 517 17.5.1 The Optimal Intervention ...... 518 17.6 Opportunities in Image-Guided Therapy: New Information Driving Invention...... 520 17.6.1 Image Guidance, Adaptation, and Innovation by the User ...... 521 17.6.2 Environments and Conditions that Support Innovations in Image-Guided Therapy...... 523 Contents xxi

17.7 Conclusion...... 525 References...... 525

18. Assessment of Image-Guided Interventions ...... 531 Pierre Jannin and Werner Korb 18.1 Introduction ...... 531 18.1.1 General Assessment Definitions...... 532 18.1.2 Complexity of Procedures and Scenarios...... 532 18.1.3 Direct and Indirect Impact of IGI Systems...... 533 18.1.4 Interdisciplinary Collaborations ...... 533 18.1.5 Human–Machine Interaction ...... 533 18.2 Assessment Methodology...... 535 18.2.1 Assessment Objective...... 536 18.2.2 Study Conditions and Data Sets ...... 541 18.2.3 Assessment Methods...... 543 18.3 Discussion ...... 545 References...... 547

Contributors

Dean Barratt University College London, London, United Kingdom

Filip Banovac Georgetown University, Washington, DC, USA

Wolfgang Birkfellner Medical University, Vienna, Austria

Jill Bruno Georgetown University Medical Center, Washington, DC, USA

Tim Carter University College London, London, United Kingdom

Rosanna Chan Washington Hospital Center, Washington, DC

Kevin Cleary Georgetown University, Washington, DC, USA

Greg Clement Brigham & Women’s Hospital, Boston, MA, USA

Bill Crum Centre for Medical Image Computing, University College London, London, United Kingdom

Sonja Dieterich Radiation Physics Division, Stanford University Medical Center, Stanford, CA, USA

xxiii xxiv Contributors Donal B. Downey Royal Inland Hospital, Kamloops, British Columbia, Canada

Chandima Edirisinghe Robarts Research Institute, London, Ontario, Canada

Fiona Fennessy Brigham & Women’s Hospital, Boston, MA, USA

Aaron Fenster Robarts Research Institute and University of Western Ontario, London, Ontario, Canada

Kirk Finnis Medtronic Inc

RL Galloway Dept of Biomedical Engineering, Vanderbilt University, Nashville, TN

Lori Gardi Robarts Research Institute, London, Ontario, Canada

Mary Gospodarowicz Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada

Michael A. Guttman National Institutes of Health, National Heart, Lung and Blood Institute, Department of Health and Human Services, Bethesda, MD

Ting Guo Robarts Research Institute and University of Western Ontario, London, Ontario, Canada

David Hawkes University College London, London, United Kingdom Contributors xxv

Anthony Hodgson University of British Columbia, Centre for Hip Health, Vancouver Hospital, Vancouver, British Columbia, Canada

D.R. Holmes III Mayo Clinic College of Medicine, Rochester, MN, USA

Keith A. Horvath National Institutes of Health, Bethesda, MD

Johann Hummel Medi cal University, Vienna, Austria

Luis Ibanez Kitware Inc., Clifton Park, NY, USA

Jonathan Irish Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada

David Jaffray University of Toronto, Ontario, Canada

Pierre Jannin INSERM, Faculté de Médecine CS, Rennes Cedex, France INRIA, Rennes, France

Ferenc Jolesz Brigham & Women’s Hospital, Boston, MA, USA

Ali Khamene Siemens Corporate Research, USA

Manabu Kinoshita Brigham & Women’s Hospital, MA, USA xxvi Contributors

Werner Korb University Leipzig, Leipzig, Germany

Robert J. Lederman National Institutes of Health, Bethesda, MD

Jamie McClelland University College London, London, United Kingdom

Nathan McDannold Brigham & Women’s Hospital, Boston, MA, USA

Elliot R. McVeigh Johns Hopkins University, Baltimore, MD, USA

W. J. Niessen Erasmus MC, Rotterdam, The Netherlands and Delft University of Technology, The Netherlands

Brian O’Sullivan Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada

Andrew Parrent London Health Sciences Centre and University of Western Ontario, London, Ontario, Canada

Terry Peters Robarts Research Institute and University of Western Ontario, London, Ontario, Canada

M.E. Rettmann Mayo Clinic College of Medicine, Rochester, MN, USA

Contributors xxvii

R.A. Robb Mayo Clinic College of Medicine, Rochester, MN, USA

James Rodgers Director of Radiation Physics, Georgetown University Hospital, Washington, DC, USA

Frank Sauer Siemens Corporate Research, USA

Jeffrey Siewerdsen Department of Medical Biophysics, University of Toronto, Ontario, Canada

Clare Tempany Brigham & Women’s Hospital, Boston, MA, USA

Sebastian Vogt Siemens Corporate Research, USA

Zhouping Wei Philips Healthcare, Cleveland, Ohio, USA

Emmanuel Wilson Georgetown University , Washington, DC, USA

Kenneth H. Wong Georgetown University, Washington, DC, USA

Jason Wright Georgetown University Medical Center, Washington, DC, USA

Ziv Yaniv Georgetown University, Washington, DC, USA

List of Abbreviations

AAM Active appearance models ABS American brachytherapy society AC Alternating current AC-PC Anterior commissural-posterior commissural AP Anterior-posterior API Application programming interface API Application user interface AR Augmented reality AVS Advanced visualization systems BBB Blood brain barrier BPH Benign prostatic hyperplasia CABG Coronary artery bypass graft CAMC Computer augmented mobile C-arm CAOS Computer-assisted orthopedic surgery CAS Computer-assisted surgery CCD Charge-coupled device CFR Code of federal regulations CT Computed tomography CTV Clinical target volume DBS Deep brain stimulation DC Direct current DICOM Digital imaging and communications DOF Degrees of freedom DRR Digitally reconstructed radiograph DSA Digital subtraction angiography DTI Diffusion tensor imaging EBRT External beam radiation therapy EMTS Electromagnet tracking systems ENT Ear, nose, and throat EP Electrophysiological FFD Free form deformation FLE Fiducial localization error FMEA Failure mode and effect analysis fMRI Functional magnetic resonance imaging FOV Field of view

xxix xxx List of Abbreviations FRACAS FRActure computer assisted surgery FRE Fiducial registration error FTA Fault tree analysis FUS Focused ultrasound GHTF Global harmonization task force GPU Graphics processing unit GRADE The grading of recommendations assessment, development and evaluation GTV Gross tumor volume GUI Graphical user interface HCTA Health care technology assessment HDR High dose rate HIFU High intensity focused ultrasound HKA Hip–knee–ankle HMD Head-mounted display HMM Hidden Markov model ICP Iterative closest point ICRU The International Commission of Radiological Units iCT Intraoperative computed tomography IEC International electrotechnical commission IGI Image-guided intervention IGS Image-guided surgery IGSTK Image-guided surgical toolkit iMRI Intraoperative magnetic resonance imaging IMRT Intensity modulated radiation therapy IR Infrared ISRCTN The International Standard Randomized Controlled Trial Number ITK Insight segmentation and registration toolkit IV Integral videography kNN k nearest neighbors kVCT Kilovoltage computed tomography kVp Peak kilovoltage LCD Liquid crystal display LED Light-emitting diodes Linac/LINAC Linear accelerator LPS Left posterior superior MEG/EEG Magneto- and electro-encephalography MER Microelectrode recording MI Mutual information MLC Multi-leaf collimator MRgFUS MRI-guided focused ultrasound MRI Magnetic resonance imaging List of Abbreviations xxxi

MV Megavoltage MVCT Megavoltage computed tomography NCC Normalized cross correlation NHLBI The National Heart, Lung, and Blood Institute of the National Institute of Health NMI Normalized mutual information NURBS Non-uniform rational B-splines OAR Organs at risk OR Operating room OTS Optical tracking systems PACS Picture archiving and communications systems PAI Pubic arch interference PCA Principal components analysis PD Parkinson’ s d isease PDE Partial differential equation pdf probability density functions PET Positron emission tomography PID Proportional integral and derivative PMMA Polyethyl methacrylate PRA Probabilistic risk analysis PRCT Prospective randomized clinical trial PRF Proton resonant frequency PRV Planning risk volume PTV Planning target volume RAS Remote access service RCT Randomized clinical trials RMS Root mean square RP Radical prostatectomy rtMRI Real time magnetic resonance imaging SAD Sum of absolute differences SBRT Stereotactic body radiation therapy SDM Statistical deformation model SISCOM Subtraction interictal SPECT co-registered to MRI SPECT Single photon emission computed tomography SPET Single photon emission tomography SRS Stereotactic radiosurgery SSD Sum of squared differences SSM Statistical shape model STARD Standard for reporting of diagnostic accuracy STN Subthalamic nucleus STS Soft tissue sarcoma xxxii List of Abbreviations SVD Singular value decomposition THA Total hip arthroplasty THR Total hip replacement TKA Total knee arthroplasty TKR Total knee replacement TRE Target registration error TRUS Transrectal ultrasound TUUS Transurethral ultrasound UML Unified modeling language UNC University of North Carolina US Ultrasound Vc Ventralis caudalis VF Virtual fluoroscopy VGA Video graphics adaptor Vim Ventralis intermedius VTK Visualization toolkit