IHE (Integrating the Healthcare Enterprise) gives guidelines on which standards in medicine shall be used in which way to achieve a specific goal. Therefore, IHE can serve as a basis to promote the usage of open standards in Computer Assisted Interventions. The paper motivates the usage of IHE in Surgery and Computer Assisted Therapy and gives examples of first IHE supplements based on already existing DICOM Supplements. An outlook on the possible focus of IHE in Surgery is given.

IHE in Surgery - Proposal for a new IHE domain

Today’s operating rooms consist of numerous medical devices, clinical IT systems and systems for computer assisted surgery. The majority of these systems comes from different vendors and has different user interface designs and interaction schemes. This diversity introduces a high risk of accidental misuse, which is critical in the surgical domain. The proposed framework integrates user interfaces of heterogeneous components into one central control console using a uniform screen design and interaction scheme. To accomplish this, the standards Universal Remote Console (URC) and Device Profiles for Web Services (DPWS) have been combined and integrated. The prototype results are demonstrated in the ICCAS integrated operating room.

User Interface Integration and Remote Control for Modular Surgical Assist Systems

This paper describes an ITK implementation of a 3D vascular segmentation filter using a graph-based energy minimization algorithm. The method first computes the shortest path between two user provided points in the vessel and then performs a graph min-cut based segmentation of the vessel based on the intensity information coupled with the computed path as a spatial constraint. The shortest path computation is adapted from the algorithm in [1] to use a vesselness based weighting function. The min-cut algorithm uses the Boost graph library to calculate the minimal cut. Several examples of applications are provided, along with images of the resulting segmentations.

Implementation of graph-based interactive 3D vessel segmentation filter

The purpose of this paper is to present our extension of the MITK toolkit by a real-time navigation system for computer assisted surgery. The system was developed with laparoscopic partial nephrectomies as a first application scenario. The main goal of the application is to enable tracking of the tumor position and orientation during surgery. Our system is based on ultrasound to CT registration and electromagnetic tracking. The basic idea is to process tracking information to generate an augmented reality (AR) visualization of a tumor model in the camera image of a laparoscopic camera. Our system will enhance the surgeon’s view on the current scene and therefore facilitates higher safety during the surgery. A key intention of the development was to use only open source toolkits such as VTK, MITK and OpenCV in order to implement the desired functionality. So far we have applied our system in vitro in two phantom trials with a surgeon which yielded promising results.

Extending MITK by a real-time online video overlay navigation system for minimally invasive surgery

The authors describe a framework for the US-guided therapeutic HIFU system for renal diseases. In particular, the HIFU system is integrated with robotic servoing capability so as to track quasi-periodically moving renal tumors and stones. The system is composed of the US imaging part, software for target detection, robot part for servoing the end-effecter, HIFU irradiation part for destroying stones and tumors, and quality assurance system for planning and maintenance of HIFU irradiations. In this paper we illustrated the overall system configurations and explained the details of each component and their integration.

Framework of US-guided therapeutic HIFU system for renal diseases

This article describes an ITK implementation of the "cuberille" method for poloygonization of implicit surfaces. The method operates by dividing the surface into a number of small cubes called cuberilles. Each cuberille is centered at a pixel lying on the iso-surface and then quadrilaterals are generated for each face. The original approach is improved by projecting the vertices of each cuberille onto the implicit surface, smoothing the typical block-like resultant mesh. Source code and examples are provided to demonstrate the method.

Cuberille Implicit Surface Polygonization for ITK

This paper describes our contribution of two new classes to the Insight Toolkit (ITK) community. This includes a base and derived ImageIO class for the JPEG2000 file formats based on the openjpeg-v2 libraries. In the current release of ITK, support for JPEG2000 is absent. Our current implementation of the JPEG2000 supports 2D images (8-bit, 16-bit and RGB) and tiling. The latest code is available in the NAMIC Sandbox SVN repository under the project JPEG2000ImageIO. We include 2D example code and tests in this submission. This code is likely to be integrated into ITKv4 very soon.

Support for Streaming the JPEG2000 File Format

This paper describes the implementation of a resampling ﬁlter for Diffusion Tensor Images (DTI) in the Insight ToolKit (ITK). ITK already contains a ﬁlter for resampling scalar and vector images as well as several transformation and interpolation classes. However, due to the directional nature of DT images, using the existing classes would result in losing the structural information of the image.
 We developed a new resampling ﬁlter, speciﬁc to DTI, that preserves the structure by applying a rotation directly on the tensors while performing the transformation of the image. New transformation and interpolator classes have also been implemented to handle tensors correctly. The new transformation classes are based on algorithms described by D.C. Alexander et al. Finally, three ﬁlters have been written to correct symmetric semi-deﬁnite matrices that would no longer be positive after the resampling process and project them into the tensors’ space. In addition, a software based on the new classes has been developed and is provided with this article.

An ITK Implementation of a Diffusion Tensor Images Resampling Filter

This document describes the implementation of image samplers using the Insight Toolkit ITK url{www.itk.org}. Image samplers take a set of `picks' from an image and store them in an array. A sample consists of the location of the pick (a point) and the corresponding image intensity (a value). Image samplers are useful for image registration, where samples are drawn from the fixed image in order to compute the similarity measure. Together with an image sampler base class, we introduce the following image samplers: 1) a full sampler that draws all voxel coordinates from the input image, 2) a grid sampler that draws samples from a user-specified regular voxel grid, 3 and 4) two random samplers that uniformly draw a user-specified number of samples from the input image.

This paper is accompanied with the source code, input data, parameters and output data that the authors used for validating the algorithm described in this paper.

An image sampling framework for the ITK

The Johns Hopkins University Surgical Assistant Workstation (SAW) modular software framework provides support for robotic devices, imaging sensors and a visualization pipeline for rapid prototyping, primarily for surgical research systems. We extend the SAW architecture for "steady hand" micromanipulation in biomanipulation laboratory tasks. The proposed system integrates direct "steady-hand" manipulation, teleoperation, and automated manipulation in a single two-handed system. System architecture, implementation and initial performance measurement experiments are detailed.