Cbyon Suite turns patient's inner body structures transparent to the surgeon's eye

Palo Alto 23 April 2001Cbyon Inc., a medical technology company, has introduced the Cbyon Suite during the recent annual meeting of the American Association of Neurological Surgeons (AANS), held in Toronto, Ontario, Canada. The advanced image guidance system is optimised for use in neuro-, sinus- and spinal surgeries. The Cbyon Suite has been based on a proprietary software platform called Perspective Volume Rendering, that is developed by surgeons and biomedical engineers from the Image Guidance Laboratory in Stanford University's Department of Neuro-surgery.

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"Existing image guidance systems are helpful in localising pathology within a patient, but have limited ability to help physicians fully visualise internal anatomy or easily orient the surgeon to the patient and to surgical tools during a minimally invasive procedure", stated Dr. Kim H. Manwaring, the director of paediatric neuro-surgery and neuro-surgery research at Phoenix Children's Hospital in Arizona, and faculty member at Barrow Neurological Institute. "The Cbyon Suite picks up where these systems leave off, offering doctors an intuitive, three-dimensional dynamic visualisation of patient-specific anatomy. It holds promise to help surgeons perform even more procedures in a minimally invasive manner, improving patient care and reducing costs."

The Cbyon platform uses powerful mathematical algorithms and computer processors to render a three-dimensional representation of targeted patient anatomy by means of diagnostic imaging data acquired pre-operatively from computed tomography (CT), magnetic resonance imaging (MRI) or positron-emission tomography (PET) scans. The Cbyon Suite then integrates the 3D representation with a variety of virtual and actual surgical tools, enabling physicians to see inside the body as never before.

"The Cbyon Suite allows physicians to create a working model of a patient's anatomy, a "virtual patient" that can be used pre-, intra- and post-operatively", stated Ramin Shahidi, PhD, director of Stanford's Image Guidance Laboratory and the scientific founder of Cbyon Inc. "Unlike existing image guidance systems which use only a portion of the available imaging data to produce surface rendered models, the Cbyon Suite maintains the integrity of the imaging data set during the rendering process. As a result, physicians can view the computer model from any perspective, even from the inside of the anatomy with an enormous degree of detail."

The Cbyon Suite integrates the basic capabilities provided by existing image guidance systems. Additionally, due to the use of Perspective Volume Rendering, the system can offer a host of additional features and modules, including:

  • Dynamic Data Filtering: This feature enables physicians to quickly and easily customise the view of the virtual patient's anatomy to their specific needs or preferences, and even make it transparent. Physicians selectively alter the displayed opacity of structures in the virtual patient, a process known as image "filtering", to emphasise, de-emphasise or remove anatomy in order to see through to the structures beyond. For example, this process allows surgeons to visualise important structures that should be targeted or avoided during surgery. Cbyon has developed sets of frequently requested, pre-defined filters for use with specific surgical procedures and with standard kinds of medical imaging data.
  • Virtual Endoscopy: This supplemental software module is part of a Cbyon workstation which is used in doctors' offices to help them plan and practice procedures prior to performing them. This software works as though a camera and light are attached to the tip of a virtual surgical tool. With it, physicians create a "tool's eye view" of a patient's internal anatomy and navigate through the virtual patient, simulating surgical approach and predicting and planning for intra-operative challenges.
    Using the software, physicians can also create cinematic fly-throughs of the surgical approach. Watching a fluid 3D movie on the Cbyon Suite display, a surgeon is able to see the internal structures of the virtual patient as if viewing them from the perspective of the surgical tool. While in this mode, the physician can use the Dynamic Data Filtering feature to gain visual access to otherwise hidden anatomy.
  • Virtual Endoscope: During surgery, the Cbyon Suite allows physicians to use any rigid instrument as a virtual endoscope, providing virtual endoscopic views from the tip of the instrument relative to its position within the patient. Using this feature, surgeons can minimise the invasiveness of procedures, because they have a better understanding of each patient's unique anatomy.
  • Virtual Fluoroscopy: This feature correlates surgical tool position with intra-operative fluoroscopic images. In spinal procedures such as discectomy, vertebroplasty, vertebral fusion, and pedicle screw placement, in which a surgeon would normally use a fluoroscope to plan and then execute the surgery, this feature allows the surgeon to simulate the fluoroscopy during the majority of the procedure, reducing the surgeon's and the patient's exposure to hazardous x-rays.
  • Dynamic Image Synchronisation: This feature is used during a surgical procedure and involves the overlay of intra-operative endoscopic images onto the Virtual Endoscopy display. Also called "Image Enhanced Endoscopy", this feature enables a surgeon to use all of the capabilities of Dynamic Data Filtering and Virtual Endoscopy while viewing live images. As a result, the surgeon has a dynamic guide to the actual patient's anatomy that provides visual access to previously hidden structures, assists in maintaining orientation, and provides navigation guidance via an intuitive interface.

Since Cbyon received clearance by the US Food and Drug Administration (FDA) for the Cbyon Suite in 2000, the company has been working with surgeons at leading institutions to optimise the platform in anticipation of a full commercial introduction. Facilities currently using the system include Barrow Neurological Institute, Massachusetts General Hospital/Harvard Medical School, and Stanford University.

"Our sales, clinical and customer service teams are queued up to introduce the system to hospitals nationwide for the core neuro-surgery, sinus surgery and spine surgery applications", stated Mitchell Seyedin, PhD, president and CEO of Cbyon. "Concurrently, our R&D team is enhancing the system to accommodate integration of real time ultrasound images, which would expand use of the system to include soft-tissue biopsy procedures and cardiac, gastrointestinal, and gynaecologic surgeries."

More news on the Cbyon Suite is available in the VMW February 2001 article Patented surgical navigation tool opens new doors to minimally invasive interventions.


Leslie Versweyveld

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