Welcome to this Special Issue of the IET journal Healthcare Technology Letters (HTL) dedicated to the 11th edition of the International Workshop on Augmented Environments for Computer-Assisted Interventions (AE-CAI). We are pleased to present the proceedings of this exciting scientific gathering held in conjunction with the Medical Image Computing and Computer-Assisted Interventions (MICCAI) conference on September 10th, 2017 in Quebec City, Canada.
The AE-CAI workshop series dates as far back as MICCAI 2006 in Denmark and has evolved as a forum to discuss the latest developments in Computer-Assisted Interventions (CAI). CAI is a field of research and practice, where medical interventions are supported by computer-based tools and methodologies. CAI systems enable more precise, safer, and less invasive interventional treatments by providing enhanced planning, real-time visualization, instrument guidance and navigation, as well as situation awareness and cognition. To promote this field of research, the AE-CAI workshops seek to showcase papers that disseminate novel theoretical algorithms, technical implementations, and development and validation of integrated hardware and software systems in the context of their dedicated clinical applications.
Rapid technical advances in medical imaging, including its growing applications to drug delivery and minimally invasive/interventional procedures, as well as a symbiotic development of imaging modalities, and nano-technological devices, have attracted significant interest in recent years. This interest has been fuelled by clinical and basic science research endeavours to obtain more detailed physiological and pathological information about the human body, to facilitate the study of localized genesis and progression of diseases. Current research has also been motivated by the development of medical imaging from being a primarily diagnostic modality toward its role as a therapeutic and interventional aid, driven by the need to streamline the diagnostic and therapeutic processes via minimally invasive visualization and therapy.
The objective of the AE-CAI workshop has been to attract scientific contributions that offer solutions to the technical problems in the area of augmented and virtual environments for computer-assisted interventions, and to provide a venue for dissemination of papers describing both complete systems and clinical applications. The community has also encouraged a broad interpretation of the field, passing the information on to scientists and engineers for the development of breakthrough therapeutics, diagnostics, and medical devices, which can then be seamlessly delivered back to patients. The workshop attracts researchers in computer science, biomedical engineering, computer vision, robotics, and medical imaging. This meeting features a single track of oral and poster presentations showcasing original research engaged in the development of virtual and augmented environments for medical image visualization and image-guided interventions.
Unlike most conference submissions, manuscripts submitted to AE-CAI 2017 are journal quality, as the ultimate objective is to publish all accepted manuscripts in this Special Issue of HTL. This year AE-CAI has received 18 manuscripts spanning a strong geographic representation from Europe, North America and Asia. The review process was rigorous and involved evaluation of each manuscript by at least three external reviewers. Following the first stage of review, fifteen manuscripts were further considered for major revision and resubmission. Authors were encouraged to submit a response to reviewers and a revised manuscript that addresses all the critiques.
Once revised, all resubmitted manuscripts entered an additional review process conducted by the AE-CAI Program Committee, Workshop Chairs, as well as the HTL Managing Editor and Editor-in-Chief to ensure that all reviewers' critiques were properly addressed in the revised manuscripts and that the quality of the manuscript was appropriate for journal publication.
In addition to the contributed papers, we were pleased to welcome two invited lectures. Dr. Michael Sacks from the University of Texas at Austin spoke on the modeling of the mitral valve for planning and simulating mitral valve repair and replacement procedures. Recent studies strongly suggest that the MV repair is the “gold standard” treatment for mitral valve regurgitation; however, follow-up investigations have revealed an undesirable high rate of failure and regurgitation recurrence following repair. Thus, in spite of the ever-increasing rate of MVR incidence, the available treatment options still need to be greatly improved. While computational simulations can provide powerful predictive tools to better understand valvular function and improve treatments for MV disease, one ongoing challenge is the development of a pipeline to quantitatively characterize and represent MV leaflet surface geometry, addressed in the invited lecture delivered by Dr. Sacks and the accompanying Opinion Piece on Mitral Valve Modeling and Simulation appearing in this Special Issue.
Dr. Sandrine de Ribaupierre from Western University and London Health Sciences Center spoke on challenges in neurosurgery and neuro-navigation and how augmented environment visualization could help ameliorate these short-comings. The past two decades have seen many attempts to use VR and AR interfaces to develop neurosurgical simulators and neuro-navigation systems. The advancement in computer power has enabled researchers to use readily available commodity technology to design simulators. Therefore, a larger range of tools is at the surgeon's disposal, from expensive commercial large-scale neuro-navigation systems to more adaptable platforms developed in-house. There are a number of challenges that must be faced when trying to develop AR and VR-based Neurosurgical simulators, Surgical Navigation Platforms, and “Smart OR” systems. Trying to simulate an operating room environment and surgical tasks in Augmented and Virtual Reality is a challenge many are attempting to solve, in order to train surgeons or help them operate. What are some of the needs of the surgeon, and what are the challenges encountered (human computer interface, perception, workflow, etc.)? The design of such systems requires an open dialog between neurosurgeons and engineers – both entities are critical in the design effort for the system to fully articulate the clinical needs – as discussed in the lecture by Dr. de Ribaupierre, accompanied by the Opinion Piece on Virtual and Augmented Reality Challenges in Clinical Neurosurgery included in this Special Issue.
On behalf of the AE-CAI 2017 Conference Chairs, we would like to extend our sincere gratitude to all authors, presenters, and attendees for their scientific contribution, enthusiasm, and support. We also extend special thanks to all reviewers for providing detailed and timely critiques of the submitted manuscripts, as well as the MICCAI Workshop Committee, and HTL Editorial Office for their dedication to maintaining the high quality of AE-CAI, and for selecting outstanding manuscripts that, with no doubt, foster a venue for exciting discussions at the meeting.
Last but not least, we acknowledge our generous sponsor – Northern Digital Inc. (NDI) of Waterloo, Canada – for their continued support over the years that has enabled us to recognize AE-CAI authors for their much deserved dedication and scientific enthusiasm through several paper awards. A big thank you on behalf of all awardees!
We hope that you will enjoy reading this Special Issue and we look forward to your continuing support and participation in future editions of the AE-CAI workshops. The continued success of AE-CAI demands our ongoing commitment.