Michael Miga

Dingrong Wang, Soheil Azadvar, Jon Heiselman et al.

The surgical environment imposes unique challenges to the intraoperative registration of organ shapes to their preoperatively-imaged geometry. Biomechanical model-based registration remains popular, while deep learning solutions remain limited due to the sparsity and variability of intraoperative measurements and the limited ground-truth deformation of an organ that can be obtained during the surgery. In this paper, we propose a novel \textit{hybrid} registration approach that leverage a linearized iterative boundary reconstruction (LIBR) method based on linear elastic biomechanics, and use deep neural networks to learn its residual to the ground-truth deformation (LIBR+). We further formulate a dual-branch spline-residual graph convolutional neural network (SR-GCN) to assimilate information from sparse and variable intraoperative measurements and effectively propagate it through the geometry of the 3D organ. Experiments on a large intraoperative liver registration dataset demonstrated the consistent improvements achieved by LIBR+ in comparison to existing rigid, biomechnical model-based non-rigid, and deep-learning based non-rigid approaches to intraoperative liver registration.

Qingyun Yang, Fangjie Li, Jiayi Xu et al.

Head and neck squamous cell carcinoma (HNSCC) has one of the highest rates of recurrence cases among solid malignancies. Recurrence rates can be reduced by improving positive margins localization. Frozen section analysis (FSA) of resected specimens is the gold standard for intraoperative margin assessment. However, because of the complex 3D anatomy and the significant shrinkage of resected specimens, accurate margin relocation from specimen back onto the resection site based on FSA results remains challenging. We propose a novel deformable registration framework that uses both the pre-resection upper surface and the post-resection site of the specimen to incorporate thickness information into the registration process. The proposed method significantly improves target registration error (TRE), demonstrating enhanced adaptability to thicker specimens. In tongue specimens, the proposed framework improved TRE by up to 33% as compared to prior deformable registration. Notably, tongue specimens exhibit complex 3D anatomies and hold the highest clinical significance compared to other head and neck specimens from the buccal and skin. We analyzed distinct deformation behaviors in different specimens, highlighting the need for tailored deformation strategies. To further aid intraoperative visualization, we also integrated this framework with an augmented reality-based auto-alignment system. The combined system can accurately and automatically overlay the deformed 3D specimen mesh with positive margin annotation onto the resection site. With a pilot study of the AR guided framework involving two surgeons, the integrated system improved the surgeons' average target relocation error from 9.8 cm to 4.8 cm.