A prototype percutaneous transhepatic cholangiography training simulator with real-time breathing motion

Written by: Pierre-Frédéric Villard, Franck P. Vidal, Carrie Hunt, Fernando Bello, Nigel W. John, Sheena Johnson and Derek A. Gould
Published on:

Summary

Purpose

We present here a simulator for interventional radiology focusing on percutaneous transhepatic cholangiography (PTC). This procedure consists of inserting a needle into the biliary tree using fluoroscopy for guidance.

Methods

The requirements of the simulator have been driven by a task analysis. The three main components have been identified: the respiration, the real-time X-ray display (fluoroscopy) and the haptic rendering (sense of touch). The framework for modelling the respiratory motion is based on kinematics laws and on the Chainmail algorithm. The fluoroscopic simulation is performed on the graphic card and makes use of the Beer-Lambert law to compute the X-ray attenuation. Finally, the haptic rendering is integrated to the virtual environment and takes into account the soft-tissue reaction force feedback and maintenance of the initial direction of the needle during the insertion.

Results

Five training scenarios have been created using patient-specific data. Each of these provides the user with variable breathing behaviour, fluoroscopic display tuneable to any device parameters and needle force feedback.

Conclusions

A detailed task analysis has been used to design and build the PTC simulator described in this paper. The simulator includes real-time respiratory motion with two independent parameters (rib kinematics and diaphragm action), on-line fluoroscopy implemented on the Graphics Processing Unit and haptic feedback to feel the soft-tissue behaviour of the organs during the needle insertion.

Award

Eurographics 2009 - Medical Prize Second prize
Bello, F., Bulpitt, A., Gould, D.A., Holbrey, R., Hunt, C., John, N.W., Johnson, S., Phillips, R., Sinha, A., Vidal, F.P., Villard, P.-F., & Woolnough, H.: "ImaGiNe-S : Imaging Guided Needle Simulation". DOI: 10.2312/egm.20091024

Publications

  • Villard, P.-F., Vidal, F. P., Hunt, C., Bello, F., John, N. W., Johnson, S., & Gould, D. A. (2009 , November). A prototype percutaneous transhepatic cholangiography training simulator with real-time breathing motion. International Journal of Computer Assisted Radiology and Surgery, 4(6), 571-578. doi:10.1007/s11548-009-0367-1
  • Bello, F., Bulpitt, A., Gould, D. A., Holbrey, R., Hunt, C., John, N. W., H. Woolnough, H., … (2009 , March). ImaGiNe-S: imaging guided needle simulation. Eurographics 2009 - Medical Prize (pp. 5–8). Munich, Germany: Eurographics Association. doi:10.2312/egm.20091024

Citations

@article{Villard2009IntJComputAssistRadiolSurg,
  author = {{P.-F.} Villard and F. P. Vidal and C. Hunt and F. Bello and N. W.
    John and S. Johnson and D. A. Gould},
  title = {A prototype percutaneous transhepatic cholangiography training simulator with real-time breathing motion},
  journal = {International Journal of Computer Assisted Radiology and Surgery},
  year = 2009,
  volume = 4,
  pages = {571-578},
  number = 6,
  month = nov,
  doi = {10.1007/s11548-009-0367-1},
  pmid = {20033333},
  keywords = {Interventional radiology; Virtual environments; Respiration simulation;
    X-ray simulation; Needle puncture; Haptics; Task analysis},
  publisher = {Springer},
}

@inproceedings{Bello2009EGMePrizde,
  author = {F. Bello and A. Bulpitt and D. A. Gould and R. Holbrey and C. Hunt and
    N. W. John and S. Johnson and R. Phillips and A. Sinha and Franck P. Vidal and 
    {P.-F.} Villard and H. Woolnough},
  title = {{ImaGiNe-S}: Imaging Guided Needle Simulation},
  booktitle = {Eurographics 2009 - Medical Prize},
  year = 2009,
  pages = {5-8},
  month = mar,
  address = {Munich, Germany},
  annotation = {Mar~30-Apr~3, 2009},
  note = {Second prize and winner of \texteuro 300},
  keywords = {Physically based modelling, Virtual reality},
  doi = {10.2312/egm.20091024},
  publisher = {Eurographics Association},
}