Purpose: Image-guided surgery requires registration between an image coordinate system and an intraoperative coordinate system that is typically referenced to a tracking device. In fiducial-based registration methods, this is achieved by localizing points (fiducials) in each coordinate system. Often, both localizations are performed manually, first by picking a fiducial point in the image and then by using a hand-held tracked pointer to physically touch the corresponding fiducial on the patient. These manual procedures introduce localization error that is user-dependent and can significantly decrease registration accuracy. Thus, there is a need for a registration method that is tolerant of imprecise fiducial localization in the preoperative and intraoperative phases.
Methods: We propose the iterative closest touchable point (ICTP) registration framework, which uses model-based localization and a touchable region model. This method consists of three stages: (1) fiducial marker localization in image space, using a fiducial marker model, (2) initial registration with paired-point registration, and (3) fine registration based on the iterative closest point method.
Results: We perform phantom experiments with a fiducial marker design that is commonly used in neurosurgery. The results demonstrate that ICTP can provide accuracy improvements compared to the standard paired-point registration method that is widely used for surgical navigation and surgical robot systems, especially in cases where the surgeon introduces large localization errors.
Conclusions: The results demonstrate that the proposed method can reduce the effect of the surgeon's localization performance on the accuracy of registration, thereby producing more consistent and less user-dependent registration outcomes.
Keywords: Fiducial marker; Registration; Surgical navigation; Surgical robot.