Soft Tissue Monitoring of the Surgical Field: Detection and Tracking of Breast Surface Deformations.

Abstract

Deformable object tracking is common in the computer vision field, with applications typically focusing on nonrigid shape detection and usually not requiring specific three-dimensional point localization. In surgical guidance however, accurate navigation is intrinsically linked to precise correspondence of tissue structure. This work presents a contactless, automated fiducial acquisition method using stereo video of the operating field to provide reliable three-dimensional fiducial localization for an image guidance framework in breast conserving surgery. On n = 8 breasts from healthy volunteers, the breast surface was measured throughout the full range of arm motion in a supine mock-surgical position. Using hand-drawn inked fiducials, adaptive thresholding, and KAZE feature matching, precise three-dimensional fiducial locations were detected and tracked through tool interference, partial and complete marker occlusions, significant displacements and nonrigid shape distortions. Compared to digitization with a conventional optically tracked stylus, fiducials were automatically localized with 1.6 ± 0.5 mm accuracy and the two measurement methods did not significantly differ. The algorithm provided an average false discovery rate <0.1% with all cases' rates below 0.2%. On average, 85.6 ± 5.9% of visible fiducials were automatically detected and tracked, and 99.1 ± 1.1% of frames provided only true positive fiducial measurements, which indicates the algorithm achieves a data stream that can be used for reliable on-line registration. Tracking is robust to occlusions, displacements, and most shape distortions. This work-flow friendly data collection method provides highly accurate and precise three-dimensional surface data to drive an image guidance system for breast conserving surgery.