i3PosNet: Instrument Pose Estimation from X-Ray in temporal bone surgery
This addresses the need for precise instrument tracking in delicate minimally invasive surgery, overcoming line-of-sight and radiation exposure issues, though it is incremental as it applies deep learning to a specific domain.
The paper tackled the problem of accurately estimating surgical instrument pose from X-ray images in temporal bone surgery, achieving errors less than 0.05mm and outperforming conventional methods by reducing average and maximum errors by at least two-thirds.
Purpose: Accurate estimation of the position and orientation (pose) of surgical instruments is crucial for delicate minimally invasive temporal bone surgery. Current techniques lack in accuracy and/or line-of-sight constraints (conventional tracking systems) or expose the patient to prohibitive ionizing radiation (intra-operative CT). A possible solution is to capture the instrument with a c-arm at irregular intervals and recover the pose from the image. Methods: i3PosNet infers the position and orientation of instruments from images using a pose estimation network. Said framework considers localized patches and outputs pseudo-landmarks. The pose is reconstructed from pseudo-landmarks by geometric considerations. Results: We show i3PosNet reaches errors less than 0.05mm. It outperforms conventional image registration-based approaches reducing average and maximum errors by at least two thirds. i3PosNet trained on synthetic images generalizes to real x-rays without any further adaptation. Conclusion: The translation of Deep Learning based methods to surgical applications is difficult, because large representative datasets for training and testing are not available. This work empirically shows sub-millimeter pose estimation trained solely based on synthetic training data.