Image-guided simulation is a recent area of research that has the potential to bridge the gap between medical imaging and clinical routine by adapting pre-operative data to the time of the procedure. Several challenges are related to image-guided therapy but the main issue consists in aligning pre-operative images onto the patient and keep this alignment up-to-date during the procedure. As most procedures deal with soft-tissues, elastic registration techniques are necessary to perform this step.
Recently, registration techniques started to account for soft tissue biomechanics using physically-based methods, yet several limitations still hinder the use of image-guided therapy in clinical routine. First, as registration methods become more complex, their computation times increase, thus lacking responsiveness. Second, techniques used for non-rigid registration or deformable augmented reality only “borrow” ideas from continuum mechanics but lack some key elements (such as identification of the rest shape, or definition of the boundary conditions). Also, these registration or augmented reality problems are highly dependent on the choice of image modality and require to investigate some aspects of computer vision or medical image processing.
However, if we can properly address these challenges, the combination of a real-time simulation and regular acquisitions of image data during the procedure opens up very interesting possibilities by using data assimilation to better adapt the model to the intraoperative data.