RESUMEN
C-arm X-ray imaging is commonly applied in operating rooms for guiding orthopedic surgeries. Augmented Reality (AR) with C-arm X-ray images during surgery is an efficient way to facilitate procedures for surgeons. However, the accurate calibration process for surgical AR based on C-arm is essential and still challenging due to the limitations of C-arm imaging systems, such as instability of C-arm calibration parameters and the narrow field of view. We extend existing methods using a depth camera and propose a new calibration procedure consisting of calibration of the C-arm imaging system, and 3D/2D calibration of an RGB-D camera and C-arm system with a new method to achieve reliable data and promising accuracy and, at the same time, consistent with standard surgical protocols. For the calibration procedure, we apply bundle adjustment equations with a 3D designed Lego multi-modal phantom, in contrast to the previous methods in which planar calibration phantoms were applied. By using our method, the visualization of the X-ray image upon the 3D data was done, and the achieved mean overlay error was 1.03 mm. The evaluations showed that the proposed calibration procedure provided promising accuracy for AR surgeries and it improved the flexibility and robustness of existing C-arm calibration methods for surgical augmented reality (using C-arm and RGB-D sensor). Moreover, the results showed the efficiency of our method to compensate for the effects of the C-arm movement on calibration parameters. It was shown that the obtained overlay error was improved for the non-zero rotation movement of C-arm by using a virtual detector.
RESUMEN
Colorectal cancer (CRC) is the second leading cause of cancer-related death in developed countries. Early detection of CRC leads to decreased CRC mortality. A blood-based CRC screening test is highly desirable due to limited invasiveness and high acceptance rate among patients compared to currently used fecal occult blood testing and colonoscopy. Here we describe the discovery and validation of a 29-gene panel in peripheral blood mononuclear cells (PBMC) for the detection of CRC and adenomatous polyps (AP). Blood samples were prospectively collected from a multicenter, case-control clinical study. First, we profiled 93 samples with 667 candidate and 3 reference genes by high throughput real-time PCR (OpenArray system). After analysis, 160 genes were retained and tested again on 51 additional samples. Low expressed and unstable genes were discarded resulting in a final dataset of 144 samples profiled with 140 genes. To define which genes, alone or in combinations had the highest potential to discriminate AP and/or CRC from controls, data were analyzed by a combination of univariate and multivariate methods. A list of 29 potentially discriminant genes was compiled and evaluated for its predictive accuracy by penalized logistic regression and bootstrap. This method discriminated AP >1cm and CRC from controls with a sensitivity of 59% and 75%, respectively, with 91% specificity. The behavior of the 29-gene panel was validated with a LightCycler 480 real-time PCR platform, commonly adopted by clinical laboratories. In this work we identified a 29-gene panel expressed in PBMC that can be used for developing a novel minimally-invasive test for accurate detection of AP and CRC using a standard real-time PCR platform.