Transcranial Magnetic Stimulation (TMS) is a neurostimulation technique based on the principle of electromagnetic induction of an electric field in the brain with both research and clinical applications. To produce an optimal neuro-modulatory effect, TMS coil must be placed on the head and oriented accurately with respect to the region of interest within the brain. A robotic method can enhance the accuracy and facilitate the procedure for TMS coil placement. This work presents two system improvements for robot-assisted TMS (RA-TMS) application. Previous systems have used outside-in tracking method where a stationary external infrared (IR) tracker is used as a reference point to track the head and TMS coil positions. This method is prone to losing track of the coil or the head if the IR camera is blocked by the robotic arm during its motion. To address this issue, we implemented an inside-out tracking method by mounting a portable IR camera on the robot end-effector. This method guarantees that the line of sight of the IR camera is not obscured by the robotic arm at any time during its motion. We also integrated a portable projection mapping device (PPMD) into the RA-TMS system to provide visual guidance during TMS application. PPMD can track the head via an IR tracker, and can project a planned contact point of TMS coil on the head or overlay the underlying brain anatomy in real-time.
Total-body photography (TBP) has gained increasing attention for facilitating early melanoma detection. TBP has advantages of monitoring temporal changes in lesions, screening a large number of lesions efficiently, and providing anatomical locations for dermatoscopic images. Since various digital imaging systems for TBP have been proposed, there is a need for a unified format for the storage of the data from TBP. Digital Imaging and Communications in Medicine (DICOM) is the international standard for medical imaging. Thanks to a considerable effort to develop dermatology-specific extensions to the DICOM standard, there is a recent supplement to the DICOM standard for individual dermoscopic images. This supplement, however, does not cover the requirements for TBP, which may include multiple wide field-of-view images. Moreover, TBP may be obtained using various methods i.e. the images can be acquired with either consumer-grade cameras, smartphones, or an automatic scanning machine. This paper provides an overview of the specific requirements and an outline of a “Work Item” leading to a Total Body Photography Information Object Definition (IOD). The “Work Item” is inclusively designed for accommodating current variants of TBP data to be compatible with the DICOM standard for dermoscopy and applicable to future systems and other potential use of TBP. We verified the feasibility of the proposed TBP DICOM in an imaging-rich full-body scanning system.
We introduce a portable projection mapping device (PPMD) for extracting and projecting implant geometric data in single-stage cranioplasty surgery. Our system consists of a real-time tracking device, which tracks the reference markers fixed on the skull, and a digitizing probe for localizing the contour of the cranial defect for modifying the oversized customized cranial implant (CCI). The feature points on the surface of the skull are registered to the reconstructed surface model of the skull obtained from CT image. The CT model is then projected on the surface of the skull. The digitizer is used to outline the geometry of the skull resection with sub-millimeter tracking accuracy. The proposed PPMD and its associated pipeline enable intraoperative cranial implant modification with image feedback to surgeons for the very first time. Our proposed PPMD system, an inexpensive device can also be used for other medical augmented reality applications, especially when direct projection mapping is preferred over the use of wearable head-mounted displays.
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