The Computation and Visualization of Uncertainty in Surgical Navigation
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The subject of this dissertation is the calculation and visualization of intraoperative measurement uncertainty in computer-assisted surgical procedures. Error is the difference between the observed or measured value and the true value (called ground-truth) of a quantity. Uncertainty is the unknown difference between the measured and true values, and exists in the absence of knowledge of ground truth. If one has an algorithm for computing the ground truth then one can get an accurate estimate of error. However, in computer-assisted surgery, the ground truth is often unknown. The introduction of error to surgical procedures is inevitable: it cannot be avoided by simply taking very careful measurements, providing more accurate algorithms, or by improving instrument calibration. One can only reduce errors as much as reasonably possible, calculate a reliable estimate of the uncertainty, and provide a meaningful way to convey this uncertainty information to clinicians. In this dissertation, I demonstrate that the visualization of registration uncertainty improves surgical navigation and that real-time computation of intraoperative measurement uncertainty is possible. In an extensive user study of surgeons and surgical residents, I compare methods of visualizing intraoperative uncertainty and determine that there are several methods of effectively conveying uncertainty in surgical navigation.