Transcript What is an Engineer Doing in The Operating Room?

High Confidence Software for
Image-Guided Therapy
Robert L. Galloway, PhD
Professor of Biomedical Engineering,
Professor of Neurosurgery, Professor of Surgery
Director, Center for Technology-Guided Therapy
Vanderbilt University, Nashville TN
Disclosure
Robert L, Galloway PhD is a Founder, President and
Chief Technical Officer of Pathfinder Therapeutics Inc
Nashville TN
TGT
Technology-Guided Therapy
The central principle behind TGT
is that therapy delivery is as
important as the therapeutic
process.
Technology-Guided Therapy
The use of images, not as
pictures but as maps.
Technology-Guided Therapy
• Need images and knowledge of the
information images convey and their
spatial characteristics.
• Need a three (or six) dimensional
tracking system.
• Need a methodology for the
visualization of path, structures and
target.
• Need a method of registration from
physical space to image spaces (s)
TGT
Image-Guided Liver Surgery
Cortical Surface Mapping
Patient #1
Comparison between digital and physical
labels:
New Surgical Applications
Colorectal Cancers
Ophthalmology
• One of the most
• Macular degeneration
prevalent cancers in leading cause of adult
the US
blindness.
• Visualization of the • Responds to drug
layered structure of
treatment of the back
the rectum is
of the eye and optic
important for staging nerves.
and therapy
New Therapeutic Applications
Gene Therapy
• Creation of Dose
distribution
• Guidance of the
placement of
sources
Cochlear Implantation
• Only available
therapy for the
profoundly deaf
• Outcome tends to
be binary
• 1% morbidity
(Facial nerve)
Software Design
ORION Software Design
Display
Video
Localizer
Optotrak
Registration
Quaternion
Tomogram
Rotational
2-D Images
Polaris
Shape Tape
Magnetic
SVD
HTM
ICP
ORION
Graphic
Render
IO
A-Mode US
Correction
Deformation
Biopsy
Preop Plan
Transparency
Electrophys.
Biomechanical
Optical Biopsy
Functional
TGT
ORION
• Based on Dynamic Link Libraries so only
functionality needed at runtime is loaded.
• Allows inclusion of new functionality
without changing underlying code.
• Written in Visual C, Windows API and runs
under Windows 98/Me/NT/2000/XP.
TGT
New Software Design
Functional Classes, Present
State
• Display
– Tomograms, rotational
sets and video
• Localizer
– Optotrak
– Polaris/Aurora
– Polhemus
– Other
• Registration
– Point-based quaternion
and SVD
– point based HTM
– ICP surface
• Graphics
– two types of overlay
supported
– on the fly rendering
(Open GL)
– Preoperative plan
• IO
– Neurostimulator
• Corrections
– Model Updated
TGT
Provocation #1
HIPAA is dangerous to patients.
Constraint of information and patient identification
will lead to patient-information mismatches.
Provocation #2
Hippocrates was wrong.
In analyzing software’s potential danger
to one subject is to deny other potential
patients timely access to the technology.
Such an approach also serves as a barrier
to revision.
Bio
Robert L. Galloway, Jr. is a Professor of Biomedical Engineering,
Neurological Surgery, and Surgery at Vanderbilt University. He teaches
courses in Medical Instrumentation, Medical Imaging and Therapeutic
Bioengineering. He has won half a dozen Excellences in Teaching and
Professor of the Year awards. Galloway's research entails the design of
systems for Interactive, Image-Guided Surgery, and holds 9 U.S. and
international patents on devices arising from his research. He has published
75 manuscripts in refereed journals, edited books, and presented results of
his work at over 90 scientific meetings. Galloway is a co-founder of
Pathfinder Therapeutics Inc. and serves as President and CTO. He received
a B.S. degree in Engineering. and Ph.D. from Duke, and a Masters in
Engineering from UVA, all in Biomedical Engineering.