HEX: a safe research framework for hybrid EMT X-ray navigation

Purpose Navigating with continuous X-ray provides visual guidance, but exposes both surgeon and patient to ionizing radiation, which is associated with serious health risks. Interleaving fluoro snapshots with electromagnetic tracking (EMT) potentially minimizes radiation. Methods We propose hybrid EMT + X-ray (HEX), a research framework for navigation with an emphasis on safe experimentation. HEX is based on several hardware and software components that are orchestrated to allow for safe and efficient data acquisition.Results In our study, hybrid navigation reduces radiation by 71% with cubic, and by 40% with linear error compensation while achieving submillimeter accuracy. Training points for compensation can be reduced by half while keeping a similar accuracy-radiation trade-off. Conclusion The HEX framework allows to safely and efficiently evaluate the hybrid navigation approach in simulated procedures. Complementing intraoperative X-ray with EMT significantly reduces radiation in the OR, increasing the safety of patients and surgeons.