Accuracy assessment of target tracking using two 5-degrees-of-freedom wireless transponders

Purpose Surgical navigation systems are generally only applied for targets in rigid areas. For non-rigid areas, real-time tumor tracking can be included to compensate for anatomical changes. The only clinically cleared system using a wireless electromagnetic tracking technique is the Calypso ® System (Varian Medical Systems Inc., USA), designed for radiotherapy. It is limited to tracking maximally three wireless 5-degrees-of-freedom (DOF) transponders, all used for tumor tracking. For surgical navigation, a surgical tool has to be tracked as well. In this study, we evaluated whether accurate 6DOF tumor tracking is possible using only two 5DOF transponders, leaving one transponder to track a tool. Methods Two methods were defined to derive 6DOF information out of two 5DOF transponders. The first method uses the vector information of both transponders (TTV), and the second method combines the vector information of one transponder with the distance vector between the transponders (OTV). The accuracy of tracking a rotating object was assessed for each method mimicking clinically relevant and worst-case configurations. Accuracy was compared to using all three transponders to derive 6DOF (Default method). An optical tracking system was used as a reference for accuracy. Results The TTV method performed best and was as accurate as the Default method for almost all transponder configurations (median errors < 0.5°, 95% confidence interval < 3°). Only when the angle between the transponders was less than 2°, the TTV method was inaccurate and the OTV method may be preferred. The accuracy of both methods was independent of the angle of rotation, and only the OTV method was sensitive to the plane of rotation. Conclusion These results indicate that accurate 6DOF tumor tracking is possible using only two 5DOF transponders. This encourages further development of a wireless EM surgical navigation approach using a readily available clinical system.