@article {Hu2022, title = {Real-time automatic tumor segmentation for ultrasound-guided breast-conserving surgery navigation}, journal = {International Journal of Computer Assisted Radiology and Surgery}, year = {In Press}, month = {05/2022}, doi = {10.1007/s11548-022-02658-4}, url = {https://doi.org/10.1007/s11548-022-02658-4}, author = {Zoe Hu and Paola V. Nasute Fauerbach and Chris Yeung and Tamas Ungi and John Rudan and C. Jay Engel and Parvin Mousavi and Gabor Fichtinger and Doris Jabs} } @article {Gauvin2019, title = {Real-time electromagnetic navigation for breast-conserving surgery using NaviKnife technology: A matched case-control study}, journal = {The Breast Journal}, volume = {26}, number = {3}, year = {2020}, month = {09/2019}, pages = {399-405}, doi = {10.1111/tbj.13480}, author = {Gabrielle Gauvin and Yeo, Caitlin T and Tamas Ungi and Shaila Merchant and Andras Lasso and Doris Jabs and Thomas Vaughan and John Rudan and Ross Walker and Gabor Fichtinger and C. Jay Engel} } @conference {Lund2019a, title = {Controlling virtual views in navigated breast conserving surgery}, booktitle = {SPIE Medical Imaging 2019}, year = {2019}, abstract = {

PURPOSE: Lumpectomy is the resection of a tumor in the breast while retaining as much healthy tissue as possible.
Navigated lumpectomy seeks to improve on the traditional technique by employing computer guidance to achieve the
complete excision of the cancer with optimal retention of healthy tissue. Setting up navigation in the OR relies on the
manual interactions of a trained technician to align three-dimensional virtual views to the patient{\textquoteright}s physical position
and maintain their alignment throughout surgery. This work develops automatic alignment tools to improve the
operability of navigation software for lumpectomies.
METHODS: Preset view buttons were developed to refine view setup to a single interaction. These buttons were
tested by measuring the reduction in setup time and the number of manual interactions avoided through their use. An
auto-center feature was created to ensure that three-dimensional models of anatomy and instruments were in the center
of view throughout surgery. Recorded data from 32 lumpectomy cases were replayed and the number of auto-center
view shifts was counted from the first cautery incision until the completion of the excision of cancerous tissue.
RESULTS: View setup can now be performed in a single interaction compared to an average of 13 interactions
(taking 83 seconds) when performed manually. The auto-center feature was activated an average of 33 times in the
cases studied (n=32).
CONCLUSION: The auto-center feature enhances the operability of the surgical navigation system, reducing the
number of manual interactions required by a technician during the surgery. This feature along with preset camera view
options are instrumental in the shift towards a completely surgeon-operable navigated lumpectomy system.

}, author = {Shaun Lund and Thomas Vaughan and Tamas Ungi and Andras Lasso and Mark Asselin and Caitlin Yeo and C. Jay Engel and Gabor Fichtinger} } @article {Yan2017b, title = {Quantification of tumor localization needle displacement prior to tumor excision in navigated lumpectomy}, year = {2017}, author = {Christina Yan and Tamas Ungi and Gabrielle Gauvin and Doris Jabs and Andras Lasso and C. Jay Engel and John Rudan and Gabor Fichtinger} } @conference {Yan2017a, title = {Study into the displacement of tumor localization needle during navigated breast cancer surgery}, booktitle = {SPIE Medical Imaging}, year = {2017}, publisher = {SPIE}, organization = {SPIE}, address = {Orlando, Florida, USA}, author = {Christina Yan and Tamas Ungi and Gabrielle Gauvin and Doris Jabs and Andras Lasso and C. Jay Engel and John Rudan and Gabor Fichtinger} } @article {Vaughan2017a, title = {Virtual views controlled by surgical tools for computer assisted interventions}, year = {2017}, author = {Thomas Vaughan and Tamas Ungi and Andras Lasso and Gabrielle Gauvin and C. Jay Engel and John Rudan and Gabor Fichtinger} } @conference {Heffernan2016, title = {Accuracy of lesion boundary tracking in navigated breast tumor excision}, booktitle = {SPIE Medical Imaging 2016}, volume = {9786}, year = {2016}, month = {03/2016}, pages = {97860Y-1-6}, address = {San Diego, CA, USA}, doi = {10.1117/12.2217017}, url = {http://proceedings.spiedigitallibrary.org/proceeding.aspx?articleid=2505913\&resultClick=1}, author = {Emily Heffernan and Tamas Ungi and Thomas Vaughan and Padina Pezeshki and Andras Lasso and Gabrielle Gauvin and John Rudan and C. Jay Engel and Evelyn Morin and Gabor Fichtinger} } @article {Gauvin2016a, title = {Breast-Conserving Surgery using NaviKnife Technology: Pilot Study on Non-Palpable Tumors}, year = {2016}, month = {08/2016}, author = {Gabrielle Gauvin and Tamas Ungi and Andras Lasso and Yeo, Caitlin T and Gabor Fichtinger and Doris Jabs and Ross Walker and Shaila Merchant and John Rudan and C. Jay Engel} } @conference {Ungi2016c, title = {Intraoperative user interface for navigated breast tumor surgery}, booktitle = {Computer Assisted Radiology and Surgery, 30th International Congress}, volume = {11}, year = {2016}, month = {05/2016}, pages = {S108-9}, publisher = {Springer}, organization = {Springer}, address = {Heidelberg, Germany}, doi = {10.1007/s11548-016-1412-5}, author = {Tamas Ungi and Thomas Vaughan and Gabrielle Gauvin and Padina Pezeshki and Andras Lasso and C. Jay Engel and John Rudan and Gabor Fichtinger} } @conference {Harish2016a, title = {Measurement of electromagnetic tracking error in a navigated breast surgery setup}, booktitle = {SPIE Medical Imaging 2016}, volume = {9786}, year = {2016}, publisher = {SPIE Medical Imaging}, organization = {SPIE Medical Imaging}, address = {San Diego, CA, United States, Feb. 29, 2016}, abstract = {

The measurement of tracking error is crucial to ensure the safety and feasibility of electromagnetically tracked, image-guided procedures. Measurement should occur in a clinical environment because electromagnetic field distortion depends on positioning relative to the field generator and metal objects. However, we could not find an accessible and open-source system for calibration, error measurement, and visualization. We developed such a system and tested it in a navigated breast surgery setup.A pointer tool was designed for concurrent electromagnetic and optical tracking. Software modules were developed for automatic calibration of the measurement system, real-time error visualization, and analysis. The system was taken to an operating room to test for field distortion in a navigated breast surgery setup. Positional and rotational electromagnetic tracking errors were then calculated using optical tracking as a ground truth. Our system is quick to set up and can be rapidly deployed. The process from calibration to visualization also only takes a few minutes. Field distortion was measured in the presence of various surgical equipment. Positional and rotational error in a clean field was approximately 0.90 mm and 0.31{\textdegree}. The presence of a surgical table, an electrosurgical cautery, and anesthesia machine increased the error by up to a few tenths of a millimetre and tenth of a degree.In a navigated breast surgery setup, measurement and visualization of tracking error defines a safe working area in the presence of surgical equipment. Our system is available as an extension for the open-source 3D Slicer platform.

}, author = {Vinyas Harish and A Baksh and Tamas Ungi and Andras Lasso and Zachary M C Baum and G Gauvin and C. Jay Engel and John Rudan and Gabor Fichtinger} } @article {Harish2016c, title = {Monitoring electromagnetic tracking error in computer-navigated breast cancer surgery}, year = {2016}, publisher = {Imaging Network Ontario (ImNO)}, address = {Toronto, Canada}, keywords = {Breast cancer, EM Tracking, Lumpectomy}, author = {Vinyas Harish and A Baksh and Tamas Ungi and Andras Lasso and Zachary M C Baum and G Gauvin and C. Jay Engel and John Rudan and Gabor Fichtinger} } @conference {Gauvin2016a, title = {Safety and Feasibility Study for Real-Time Electromagnetic Navigation in Breast-Conserving Surgery}, booktitle = {Computer Assisted Radiology and Surgery, 30th International Congress}, volume = {11}, year = {2016}, month = {05/2016}, pages = {S106-7}, publisher = {Springer}, organization = {Springer}, address = {Heidelberg, Germany}, doi = {10.1007/s11548-016-1412-5}, author = {Gabrielle Gauvin and Tamas Ungi and Andras Lasso and Ross Walker and John Rudan and Gabor Fichtinger and C. Jay Engel} } @conference {Carter2016a, title = {Visual feedback mounted on surgical tool: proof of concept}, booktitle = {SPIE Medical Imaging 2016}, volume = {9786}, year = {2016}, month = {In Press}, address = {San Diego, CA, USA}, author = {Kaci Carter and Thomas Vaughan and M. Holden and Gabrielle Gauvin and Padina Pezeshki and Andras Lasso and Tamas Ungi and Evelyn Morin and John Rudan and C. Jay Engel and Gabor Fichtinger} } @article {Ungi2015c, title = {Clinical Translation of Real Time Cautery Navigation for Breast Surgery}, year = {2015}, month = {06/2015}, pages = {19-20}, isbn = {978-0-9563776-6-1}, author = {Tamas Ungi and Gabrielle Gauvin and Andras Lasso and Yeo, Caitlin T and John Rudan and C. Jay Engel and Gabor Fichtinger} } @article {Ungi2015b, title = {Navigated breast tumor excision using electromagnetically tracked ultrasound and surgical instruments}, journal = {IEEE Transactions on Biomedical Engineering}, year = {2015}, month = {08/2015 }, abstract = {

OBJECTIVE:

Lumpectomy, breast conserving tumor excision, is the standard surgical treatment in early stage breast cancer. A common problem with lumpectomy is that the tumor may not be completely excised, and additional surgery becomes necessary. We investigated if a surgical navigation system using intraoperative ultrasound improves the outcomes of lumpectomy, and if such a system can be implemented in the clinical environment.

METHODS:

Position sensors were applied on the tumor localization needle, the ultrasound probe, and the cautery, and three-dimensional navigation views were generated using real time tracking information. The system was tested against standard wire-localization procedures on phantom breast models by eight surgical residents. Clinical safety and feasibility was tested in six palpable tumor patients undergoing lumpectomy by two experienced surgical oncologists.

RESULTS:

Navigation resulted in significantly less tissue excised compared to control procedures (10.3 {\textpm} 4.4 vs. 18.6 {\textpm} 8.7 g, p = 0.01) and lower number of tumorpositive margins (1/8 vs. 4/8) in the phantom experiments. Excision-tumor distance was also more consistently outside the tumor margins with navigation in phantoms. The navigation system has been successfully integrated in an operating room, and user experience was rated positively by surgical oncologists.

CONCLUSION:

Electromagnetic navigation may improve the outcomes of lumpectomy by making the tumor excision more accurate.

SIGNIFICANCE:

Breast cancer is the most common cancer in women, and lumpectomy is its first choice treatment. Therefore, improvement of lumpectomy outcomes have a significant impact on a large patient population.

}, issn = {0018-9294}, doi = {10.1109/TBME.2015.2466591}, url = {http://www.ncbi.nlm.nih.gov/pubmed/26302503}, author = {Tamas Ungi and Gabrielle Gauvin and Andras Lasso and Yeo, Caitlin T and Padina Pezeshki and Thomas Vaughan and Kaci Carter and John Rudan and C. Jay Engel and Gabor Fichtinger} } @conference {Ungi2015a, title = {Real Time Navigation In Breast Tumor Surgery}, booktitle = {Computer Assisted Radiology and Surgery, 29th International Congress}, volume = {10}, year = {2015}, month = {06/2015}, pages = {S59-60}, doi = {10.1007/s11548-015-1213-2}, author = {Tamas Ungi and Gabrielle Gauvin and Yeo, Caitlin T and C. Jay Engel and John Rudan and Gabor Fichtinger} } @article {Gauvin2014b, title = {Real-time electromagnetic navigation for breast tumor resection: proof of concept}, year = {2014}, month = {06/2014}, address = {Kingston, ON, Canada}, author = {Gabrielle Gauvin and Yeo, Caitlin T and Tamas Ungi and Gabor Fichtinger and John Rudan and C. Jay Engel} } @article {Gauvin2014c, title = {Real-Time Electromagnetic Navigation for Breast Tumor Resection: Proof of Concept}, year = {2014}, month = {09/2014}, address = {Vancouver, BC, Canada}, author = {Gabrielle Gauvin and Yeo, Caitlin T and Tamas Ungi and C. Jay Engel and Gabor Fichtinger and John Rudan} } @conference {Gauvin2014d, title = {Real-time electromagnetic navigation for breast tumor resection: proof of concept}, booktitle = {The Hamlyn Symposium on Medical Robotics}, year = {2014}, month = {07/2014}, pages = {39-40}, address = {London, UK}, author = {Gabrielle Gauvin and Yeo, Caitlin T and Tamas Ungi and Gabor Fichtinger and John Rudan and C. Jay Engel} } @article {Gauvin2014a, title = {Real-time EM navigated breast conserving surgery: phantom and cadaver experiments}, year = {2014}, month = {09/2014}, address = {Cambridge, MA, USA}, author = {Gabrielle Gauvin and Yeo, Caitlin T and Tamas Ungi and Gabor Fichtinger and Nanji, Sulaiman and John Rudan and C. Jay Engel} }