IFL: Interdisziplinäres Forschungslabor
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IFL is a central research laboratory open for joint projects of the medical and non-medical groups of the Technische Universität München. Its goal is consequently to encourage interdisciplinary work and discussion between Applied Sciences, Engineering and Medicine in close contact with physicians in order to generate new lines of applied research in Medical Technology and Computer- and Robot-Aided Medical Procedures.
A further goal of IFL is to be a show-room for current research in the area in order to keep both the medical personnel at the Klinikum rechts der Isar and the community informed of latest results and thus obtain early feedback and encourage new collaborations.
Mailing address:
Thomas Wendler
Nuklearmedizinische Klinik und Poliklinik
Klinikum rechts der Isar
Ismaninger Str. 22
81675 München
Phone: +49 (89) 4140-6457
Fax: +49 (89) 4140-6458
Contact details and directions to IFL can be found here.
Internal Website
All you want to know about IFL.
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Facilities
IFL consists in a 140 m2 lab, a 28 m2 conference room and a fully equipped operation room.
In particular, starting in 2007, the new facilities of the Chair of Computer-Aided Medical Procedures at IFL include:
- two 4-camera infrared optical tracking systems
- three magnetic tracking systems
- a sonograph with tracked ultrasound probe
- a nuclear probe suite with tracked beta and gamma probes
- various surgical instruments
- phantoms
- etc
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CAMP Research Projects @ IFL
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A common task during broncoscopy procedures is to biopsy peripheral lung tumors. The video bronchoscope is not capable to reach the peripheral lung nodes, but only the biopsy needle. Thus there is no video feedback, but only feedback of the current location of the biopsy tool by fluoroscopy imaging during the intervention. This exposes patient and surgical staff to additional radiation. Another drawback is that tumors can not be visualized on the fluoroscope images and they are only a projection, thus do not report the three dimensional position of the biopsy tool. Electromagnetic tracking is capable of tracking the tip of flexible instrument. A field generator with three orthogonal coils introduces current and thus generates a magnetic field. A sensor composed also of three orthogonal coils is capable to estimate its position and orientation with respect to a coordinate system defined by the field generator. Currently we investigate the combination of all available information for navigation and solutions to represent it in one unified user interface. This includes the measurements of the electromagnetic tracking system, the c-arm, techniques of virtual bronchoscopy, and other data. Furthermore, clinical evaluation is conducted. We define the clinical endpoint and show through studies that the procedure will benefit from the usage of the navigation system.
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Stroke is the third leading cause of death in Germany. It is a neurology injury, whereby the oxygen supply to parts of the brain gets cut off. About 80% of these strokes are due to ischemia, i.e. an occlusion of a blood vessel leading to an interrupted blood flow. Stenosis inside the carotid artery imaged using four different MR weightings Special setting in this project is the arteria carotis. Plaque is most likely to develop at the branching of the arteria carotis communis into the arteria carotis interna (leading to the brain) and the arteria carotis externa. This can lead to an abnormal narrowing, called a stenosis. According to the American Heart Association these plaques can be divided into different types, based on their consistency and structure. Until now the decision about a surgery was only based on the degree of the stenosis and not on the type of plaque causing it. This is a faulty approach since there is a plaque type (Type IV) which constitutes a relevant clinical danger, although it does not necessary come along with a stenosis. Unlike most other image modalities MR images do not only give information about the degree of the stenosis, but also about the consistency of the plaque. Using different weighted MR images it is possible to correctly classify plaque into the types defined by the AHA. The main goal of this project is to create a classification tool based on T1, T2, Proton Density and 'Time of flight' weighted images. To achieve this goal the arteria carotis and the plaque have to be segmented from the images. Furthermore various features of the plaque have to be extracted in order to get information needed for the classification.
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Nuclear medicine imaging modalities assist commonly in surgical guidance given their functional nature. However, when used in the operating room they present limitations. Pre-operative tomographic 3D imaging can only serve as a vague guidance intra-operatively, due to movement, deformation and changes in anatomy since the time of imaging, while standard intra-operative nuclear measurements are limited to 1D or (in some cases) 2D images with no depth information. To resolve this problem we propose the synchronized acquisition of position, orientation and readings of gamma probes intra-operatively to reconstruct a 3D activity volume. In contrast to conventional emission tomography, here, in a first proof-of-concept, the reconstruction succeeds without requiring symmetry in the positions and angles of acquisition, which allows greater flexibility and thus opens doors towards 3D intra-operative nuclear imaging.
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Surgical workflow recovery is a crucial step towards the development of intelligent support systems in surgical environments. The objective of the project is to create a system which is able to recognize automatically the current steps of a surgical laparoscopic procedure using a set of signals recorded from the OR. The project adresses several issues such as the simultaneous recordings of various signals within the OR, the design of methods and algorithms for processing and interpreting the information, and finally the development of a convenient user interface to display context sensitive information inside the OR. The current clinical focus is on laparoscopic cholecystectomies but the concepts developed in the project also apply to laparoscopic surgeries of other kinds.
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In minimally invasive tumor resection, the goal is to perform a minimal but complete removal of cancerous cells. In the last decades interventional beta probes supported the detection of remaining tumor cells. However, scanning the patient with an intraoperative probe and applying the treatment are not done simultaneously. The main contribution of this work is to extend the one dimensional signal of a nuclear probe to a four dimensional signal including the spatial information of the distal end of the probe. This signal can be then used to guide the surgeon in the resection of residual tissue and thus increase its spatial accuracy while allowing minimal impact on the patient.
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Subject of this project is the development of dedicated reconstruction algorithms for PET which take patient movements into account. Positron-emission-tomography (PET) is nowadays a well-established tool for diagnosing, staging and monitoring diseases in patients. However, due to the long acquisition times which are necessary for a PET scan, patient movements are often unavoidable. Patient motion during data acquisition can cause image blurring and even severe artifacts in the reconstructed image, thus posing a significant problem for further diagnosis and treatment. To date, available algorithms have been tested only on synthetic data since they rely on general transformation data of the patient which are currently not practically available. We aim at developing algorithms that work on partial transformation data that will be delivered e. g. by new laser cameras or com-bined PET/MRT machines.
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Age related macula degeneration (AMD) is the most common cause in the western hemisphere for going blind in advanced years. The incidence of the population being older than 60 is at the moment rapidly increasing and especially elder people suffer through the loss of the reading ability in their quality of life. Thanks to modern image processing methods and the principle of mediated-reality an individually adapted image of a camera mounted to a head-mounted-display ought to be shown to the patient. The way in which the image needs to be changed for each patient will be computed based on verifiable information from the patient about his defect. Hereunto existing systems, e.g. Pereferential Hyperacuity Permetry, will be evaluated and if needed a specialized system will be developed. The presented information will be individually adapted to the defect of each patient and targets at combining high resolution and a wide field of view. Besides individual adaption, the system to be developed shall allow the user to interactively adapt to advanced progress of his medical condition.
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Intra-operative localization of non-superficial cancerous lesions in non-hollow organs like liver, kidney, etc is currently facilitated by intra-operative ultrasound (IOUS) and palpation. This yields a high rate of false positives due to benign abnormal regions and thus unnecessary resections with increased complications and morbidity. In this project we integrate functional nuclear information from gamma probes with IOUS, to provide a synchronized, real-time visualization that facilitates the detection of active tumors and metastases intra-operatively. The bet of this project is that the inclusion of an advanced, augmented visualization provides more reliability and confidence on classifying lesions prior to the resection.
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An abdominal aortic aneurysm (AAA) describes an enlarged aortic diameter in the abdominal part of the body. Due to weakening rupture of the inner aortic wall layer, blood cells accumulate inside the wall layers and lead to a thrombus. In order to choose a suitable individual treatment, a prediction of rupture risk would be helpful. However, it is not possible to predict the ruputure risk only with quantative parameters extracted out of CT-images such as size and diameter. It is important to also include qualitative predictors like characteristics of the aortic wall and fluid dynamics.
Together with our medical and academic partners, we are interested in creating a model of the aorta and its thrombus in order to do certain calculations on wall stress and fluid dynamic computations. A further integration of other medical imaging devices such as PET/CT and IVUS into the geometrical model can provide more information about biochemical activities inside the aneurysmatic walls.
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In recent years, an increasing number of liver tumor indications were treated by minimally invasive laparoscopic resection. Besides the restricted view, a major issue in laparoscopic liver resection is the precise localization of the vessels to be divided. To navigate the surgeon to these vessels, pre-operative imaging data can hardly be used due to intra-operative organ deformations caused by appliance of carbon dioxide pneumoperitoneum and respiratory motion.
Therefore, we propose to use an optically tracked mobile C-arm providing cone-beam computed tomography imaging capability intra-operatively. After patient positioning, port placement, and carbon dioxide insufflation, the liver vessels are contrasted and a 3D volume is reconstructed during patient exhalation. Without any further need for patient registration, the volume can be directly augmented on the live laparoscope video. This augmentation provides the surgeon with essential aid in the localization of veins, arteries, and bile ducts to be divided or sealed.
Current research focuses on the intra-operative use and tracking of mobile C-arms as well as laparoscopic ultrasound, augmented visualization on the laparoscope's view, and methods to synchronize respiratory motion.
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In abdominal surgery, a laparoscopic ultrasound transducer is commonly used to detect lesions such as metastases. The determination and visualization of position and orientation of its flexible tip in relation to the patient or other surgical instruments can be of much help to (novice) surgeons utilizing the transducer intraoperatively. This difficult subject has recently been paid attention to by the scientific community. Electromagnetic tracking systems can be applied to track the flexible tip. However, the magnetic field can be distorted by ferromagnetic material.
We present a new method based on optical tracking of the laparoscope and magneto-optic tracking of the transducer, which is able to automatically detect and correct field distortions. This is used for a smooth augmentation of the B-scan images of the transducer directly on the camera images in real time.
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