Software for MR image overlay guided needle insertions: The clinical translation process

Tamas Ungi, Paweena U-Thainual, Jan Fritz, Iulian I. Iordachita, Aaron J. Flammang, John A. Carrino, Gabor Fichtinger

Research output: Chapter in Book/Report/Conference proceedingConference contribution


PURPOSE: Needle guidance software using augmented reality image overlay was translated from the experimental phase to support preclinical and clinical studies. Major functional and structural changes were needed to meet clinical requirements. We present the process applied to fulfill these requirements, and selected features that may be applied in the translational phase of other image-guided surgical navigation systems. METHODS: We used an agile software development process for rapid adaptation to unforeseen clinical requests. The process is based on iterations of operating room test sessions, feedback discussions, and software development sprints. The open-source application framework of 3D Slicer and the NA-MIC kit provided sufficient flexibility and stable software foundations for this work. RESULTS: All requirements were addressed in a process with 19 operating room test iterations. Most features developed in this phase were related to workflow simplification and operator feedback. CONCLUSION: Efficient and affordable modifications were facilitated by an open source application framework and frequent clinical feedback sessions. Results of cadaver experiments show that software requirements were successfully solved after a limited number of operating room tests.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2013
Subtitle of host publicationImage-Guided Procedures, Robotic Interventions, and Modeling
StatePublished - 2013
Externally publishedYes
EventMedical Imaging 2013: Image-Guided Procedures, Robotic Interventions, and Modeling - Lake Buena Vista, FL, United States
Duration: Feb 12 2013Feb 14 2013

Publication series

NameProceedings of SPIE - The International Society for Optical Engineering
ISSN (Print)0277-786X


OtherMedical Imaging 2013: Image-Guided Procedures, Robotic Interventions, and Modeling
Country/TerritoryUnited States
CityLake Buena Vista, FL


  • Augmented reality
  • Open-source software
  • Surgical navigation

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Condensed Matter Physics
  • Computer Science Applications
  • Applied Mathematics
  • Electrical and Electronic Engineering


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