Real-time automatic registration in optical surgical navigation

An image-guided surgical navigation system requires the improvement of the patient-to-image registration time to enhance the convenience of the registration procedure. A critical step in achieving this aim is performing a fully automatic patient-to-image registration. This study reports on a design of custom fiducial markers and the performance of a real-time automatic patient-to-image registration method using these markers on the basis of an optical tracking system for rigid anatomy. The custom fiducial markers are designed to be automatically localized in both patient and image spaces. An automatic localization method is performed by registering a point cloud sampled from the three dimensional (3D) pedestal model surface of a fiducial marker to each pedestal of fiducial markers searched in image space. A head phantom is constructed to estimate the performance of the real-time automatic registration method under four fiducial configurations. The head phantom experimental results demonstrate that the real-time automatic registration method is more convenient, rapid, and accurate than the manual method. The time required for each registration is approximately 0.1 s. The automatic localization method precisely localizes the fiducial markers in image space. The averaged target registration error for the four configurations is approximately 0.7 mm. The automatic registration performance is independent of the positions relative to the tracking system and the movement of the patient during the operation.