C-arm fluoroscopes are frequently used during surgeries for intraoperative guidance. Unfortunately, due to X-ray emission and scattering, increased radiation exposure occurs in the operating theatre. The objective of this work is to sensitize the surgeon to their radiation exposure, enable them to check on their exposure over time, and to help them choose their best position related to the C-arm gantry during surgery. First, we aim at simulating the amount of radiation that reaches the surgeon using the Geant4 software, a toolkit developed by CERN. Using a flexible setup in which two RGB-D cameras are mounted to the mobile C-arm, the scene is captured and modeled respectively. After the simulation of particles with specific energies, the dose at the surgeon's position, determined by the depth cameras, can be measured. The validation was performed by comparing the simulation results to both theoretical values from the C-arms user manual and real measurements made with a QUART didoSVM dosimeter. The average error was 16.46% and 16.39%, respectively. The proposed flexible setup and high simulation precision without a calibration with measured dosimeter values, has great potential to be directly used and integrated intraoperatively for dose measurement.

We present a prototype of a system in development for pre-operative planning. The proposed NeuroTable uses a combination of traditional rendering and novel visualization techniques rendered to facilitate real-time collaboration between neurosurgeons during intervention planning. A set of multimodal 2D and 3D renderings convey the relation between the region of interest and the surrounding anatomical structures. A haptic device is used for interaction with the NeuroTable to facilitate immersive control over the 3D cursor and navigation modes for the neurosurgeons during their discourse of planning. A pilot experimental study was conducted to assess the performance of users in targeting points within the preoperative 3D scan. Then, two clinicians participated in the evaluation of the table in discussing and planning a case. Results indicate that the NeuroTable facilitated the discourse and we discuss the results of the speed and accuracy for the specification of entry and target points.

We present a unique simulator-based methodology for assessing both technical and nontechnical (cognitive) skills for surgical trainees while immersed in a complete medical simulation environment. Further, we have included two crisis scenarios which allow for the evaluation of the effect of cognitive strategy selection on the low-level surgical skills. Training these mixed-mode scenarios can thereby be evaluated on our platform, allowing for improved assessment and a stronger foundation for credentialing, with the potential to reduce the occurrence of adverse events in the operating room. Scientific evaluation and validation of our work is conducted together with 19 junior surgeons in order to achieve the following goals: 1) to provide a qualitative measure of usability, 2) to assess vertebroplasty technical performance of the surgeon, and 3) to explore the relationship between mental workload and surgical performance during crisis. Our results indicate that: 1) the surgeons scored the face validity of our modeled simulation environment very highly ( 4.68 ±0.48, using a 5-point Likert scale), 2) surgeon training enabled completion of tasks more quickly, and 3) the introduction of crisis scenarios negatively affected the surgeons' objective performance. Taken together, our results underscore the need to develop realistic simulation environments that prepare young residents to respond to emergent events in the operating room.

We present a medical Augmented Reality (AR) edutainment system for bone anatomy learning. This learning environment, called AR bone puzzle, is a metaphor for bone anatomy learning with AR visualization and intuitive interaction. AR bone puzzle uses its user's body as a puzzle frame and computer generated virtual bones as puzzle pieces. Users learn bone anatomy by assembling the virtual bone pieces on their body. Key features of this system are 3D AR visualization and intuitive gesture based user interaction.