1.1. Definitions

1.1.1. Learning Objectives

Upon completion of this section, the student will be able to

  • explain commonly used acronyms in the field

  • identify suitable terminology for specific audiences

1.1.2. Nomenclature

You may see:

  • CAS - Computer Assisted Surgery

  • CAI - Computer Assisted Interventions

  • IGS - Image-Guided Surgery

  • IGT - Image-Guided Therapy

  • IGI - Image-Guided Interventions

Ziv Yaniv has a few more!

1.1.3. Communities

The field of “Computer Assisted Surgery and Therapy”, which is the title of this module, brings together clinical and technical communities.

1.1.3.1. Surgeons

Cardiac surgery operating room

Fig. 1.1 Figure: “Cardiac surgery operating room”, by Pfree2014, is licensed under CC BY-SA 4.0.

Surgery can be defined as a procedure involving cutting, or joining together a person’s tissues for the purpose of diagnosis or treatment (Wikipedia). Surgeons do surgery in an operating room or operating theatre. Most operating theatres do not have large imaging devices in. Some operating theatres may have a C-arm X-ray machine. Portable imaging devices such as endoscopy or laparoscopy stacks or ultrasound machines are brought in as necessary.

1.1.3.2. Interventional Radiologists

An electric current produced by radiofrequency ablates the tumor

Fig. 1.2 Figure: “An electric current produced by radiofrequency ablates the tumor”, by https://www.scientificanimations.com/, is licensed under CC BY-SA 4.0.

Interventional Radiologists, or Vascular and Interventional Radiologists perform their procedures in an Interventional Radiology Suite, or Vascular Suite, that is equiped with built-in large imaging devices, like a Siemens Zeego.

The Mauro et al., “Image-Guided Interventions” book, comes from the perspective of Interventional Radiology. Interventional Radiologists have been using image-guidance for decades to perform a wide variety of interventional procedures. These suite’s typically have X-ray flouroscopy, Cone Beam CT etc.

Interventional Radiologists routinely do image-guided procedures, and they would call them “Image-Guided Interventions”. However, engineers in the field of CAS/CAI may not call them “Computer Assisted Surgery” or “Computer Assisted Interventions”, as there is no additional computer.

1.1.3.3. Surgery + Imaging

Recently, combined surgical and imaging/interventional radiology suite’s have been developed. The most notable of which, at the time of writing, is the Siemens AMIGO suite.

See: https://ncigt.org/amigo

at the Ferenc Jolesz National Centre for Image-Guided Therapy. Ferenc Jolesz is also the author of Jolesz et al., “Intraoperative Imaging and Image-Guided Therapy”.

Hybrid operating room for cardiovascular surgery at Agostino Gemelli University Polyclinic in Rome

Fig. 1.3 Figure: “Hybrid operating room for cardiovascular surgery at Agostino Gemelli University Polyclinic in Rome”, by Pfree2014, is licensed under CC0.

1.1.4. Summary

Therefore, we define:

  • Surgery - a procedure involving cutting, or joining together a person’s tissues (Wikipedia).

  • Therapy - treating a medical condition, e.g. radio-frequency ablation

  • Interventions - broader term, encapsulating both surgical procedures and therapies

  • Computer Assisted - using an additional computational system, above and beyond that provided by the manufacturer of an imaging device

hence MPHY0026: “Computer Assisted Surgery and Therapy”.

1.1.5. Caveats

  • Prototype CAS systems may eventually become embeded in clinical practice and indistinguishable from imaging devices.

1.1.6. Hot off The Press!

  • See this paper, by [Giminez2020] and colleagues, a first go at clarifying terminology.