1. Slicer IGT and Open IGT Link
Nobuhiko Hata, PhD
Sandy Wells, PhD
Computation Core

2. National Center for Image-Guided Therapy www.ncigt.org
Surgical Planning Lab, Harvard Medical School
Surgical Navigation and Robotics Laboratory
National Alliance for Medical Image Computing
Intelligent Surgical Instrument Project, Japan

3. Slicer in IGT
To facilitate application of state-of-art medical image processing in IGT
IGT specific extension to support this translation

4. Software Design To maximize function commonalities among applications
Brain (biopsy, craniotomy, NdYAG laser ablation)
Prostate (brachytherapy, biopsy)
Liver and kidney (Microwave, Cryo, laser ablation)
Endoscopy (broncho-, neuro-, feto-scopy)

5. MRg Prostate Therapy
Segmentation tool for Brachytherapy Planning and Biopsy
Navigation for Biopsy
Future FUS and Robot Applications
Please highlight our effort to develop new SIGN with focus on tracker I/O. The effort enabled integration of shared tracker I/O tool to current slicer. Please also highlight the need for improving fast graphics from the video, which again is part of IGT-specific Slicer.

6. Role of Slicer in MRg Prostate Therapies
DICOM image transfer
Planning
Scanner control
Rigid and non-rigid image registration
Pre-op MRI
+Pre-procedural MRI
+Intra-procedural MRI
Radiology 220(1), , 2001

7. MR-guided laser ablation
MRI Thermal image reconstruction in 3D Slicer
Guidance with thermal images to minimize “uncooked” lesion
New 3D temperature mapping from Imaging Core to be implemented in the future
Demostrating: (1) thermal image overlayed on Sagital view,(2) uncooked lesion only visible in axial view available in Slcier, (3) leaving marker in uncooked lesion, (4) guiding additional needle to the uncooked lesion
Movie prepared by Hata

8. MR-guided neurosurgery
MRI-guided brain tumor surgery guided with fMRI and diffusion tensor tractography
Toward Spatial Neuroinformatics for Functional Localization (P.I. Wells)
Video: fMRI registered to intraop MRI using deofrormaable registration. Fused images are used in navigation. Top left, pre-crani SPGR and fmri, bottom left, after crani with deformed fmri, bottom right pre-operative T2 registered with non-deformed fmri.
Movie prepared by Hata, Warfield, Golby

9. Open IGT Link Inter-device communication mechanism
Enables exchange of coordinates, images, control commands
Open protocol
History
Needs indentified during IGT Programming event in Dec, 2008
Design discussion during a NA-MIC programming event (Jan, 2008)
Initial implementation by NIH-funded IGT researchers in Spring 2008

10. An example: MRg Prostate intervention
Commercial Software
Interface
image visualization
planning
biopsy targets
rad. dose
brachy. seed targets
image registration
Pre-op ↔ intra-op
multi-parametric (SSM)
interventional image visualization (in room)
RT image processing
robot localization
Robot calibration
needle localization
seed localization
DICOM
Server (?)
MRI
Host
MRI
Scanner
Real-Time
Image Controller
image recon
plane control
SPLOT
Raw Data
Server
SPLOT
SPLOT
RSP
Modifier
SPLOT
Image
Processor (?)
Robot
Controller
Robotic
Manipulator
Driver Control
Interface   ?
Research Interface
Image visualization
Planning (biopsy targets)
Image registration (pre ↔ intra)
Interventional visualization
RT image processing (fiducial)

11. Endorsement by IGT research community
DelNido BRP
Surgical robotics research community

12. Open IGT Link and IGSTK
IGSTK is a software interface to commercial trackers
NDI Polaris, NDI Aurora, Ascension Flock of Birds, and Ascension Microbird
IGSTK has Open IGT Link interface.
Access to all IGSTK supported devices in Slicer 3
Work was done by Kitware, Georgetown, SPL with funding from NA-MIC collaboration grant (PI Cleary)

13. Intra-operative Seeding of Tractography
Use tracking device to
Seed tractography at the location of neurosurgical lesion
Internal collaboration with Neurosurgery Core

14. Conclusion 3D Slicer Open IGT Link Future Plan
Useful tool for IGT software development
Facilitates collaboration and dissemination
Open IGT Link
New development from Year 3
Community building for IGT scientists working with variety of vendors and applications
Future Plan
Continuing effort to extend Slicer 3 for new IGT
Service/dissemination