IGSTK: An Open Source Software Toolkit for Image-Guided Surgery

Software is a critical technology in image-guided surgery systems, which have tightly coupled components, complex mathematical processes, and demanding synchronization constraints. The software must integrate information from tracking systems, correlate this data with the relevant images, and display real-time updates of the instruments and patient anatomy. Moreover, because it is used in life-critical applications, the software must be carefully designed to ensure ease of use, robustness, and stability.

Dr. Kevin Cleary is the deputy director of the Department of Radiology’s Imaging Science and Information Systems (ISIS) Center at Georgetown University Medical Center (Washington, DC, USA). For the last five years, Dr. Cleary has been leading a group of researchers in developing image-guided systems for abdominal interventions. As is the case with many research labs today, the software development effort was representing a large portion of the work. Most software projects are started from scratch, and a great deal of time and effort is spent ‘re-inventing the wheel’. After several years of developing new software applications, the research group decided to standardize their software process based on the open source software packages VTK (Visualization Toolkit) and ITK (Insight Segmentation and Registration Toolkit). While these packages provided an excellent start, the group noted that further progress could be made by developing a set of components specifically for image-guided applications. A partnership was formed with Kitware, Inc., a leading open source software company, and a small business proposal was submitted to the National Institutes of Health. A grant award was received to develop the software toolkit, and several other collaborators later joined the project, including the University of North Carolina, Atamai Inc., the Arizona State University, and SINTEF Health Research of Trondheim, Norway.

The result is IGSTK, the Image-Guided Surgery Toolkit. IGSTK (commonly pronounced ‘ I-G-stick’) is designed to enable biomedical researchers to rapidly prototype and create new applications for image-guided surgery. The cornerstone of IGSTK is robustness. The toolkit provides the following high-level functionality:

• the ability to read and display medical images including CT and MRI in DICOM format
• an interface to common tracking hardware
• a graphical user interface and visualization capability including a four-quadrant view as well as a multi-slice axial view
• point based registration and a means for selecting these points
• common internal software services for logging, exception-handling, and problem resolution

Because IGSTK is an open source project, developers and companies around the world can use, debug, maintain, and extend the software. IGSTK uses a model of software development referred to as Extreme Programming, the key features of which are communication and testing. Communication among the members of the IGSTK community is what helps manage the rapid evolution of the software. Testing is what keeps the software stable.

Image-guided surgery applies leading-edge technology and clinical practices to provide better quality of life to patients who can benefit from minimally invasive procedures. Reliable software is a critical component of image-guided surgical applications, and IGSTK applies agile and component-based software engineering principles to reduce the costs and risks associated with adopting this new technology. The result is a safe, inexpensive, robust, shareable, and reusable software infrastructure. The software is currently being used in a clinical trial of image-guided surgery and electromagnetic tracking for lung biopsy at Georgetown University Medical Center.

For further information or to download the software, see the Web site www.igstk.org or contact the project leader Kevin Cleary at cleary@georgetown.edu. The project is supported by NIBIB/NIH R01EB007195.

References:

1. Gary, Kevin; Ibanez, Luis; Aylward, Stephen; Gobbi, David; Blake, M. Brian; Cleary, Kevin; "IGSTK: An Open Source Software Toolkit for Image-Guided Surgery," Computer, vol. 39, no. 4, pp. 46-53, April 2006.
2. Enquobahrie A, Cheng P, Gary K, Ibanez L, Gobbi D, Lindseth F, Yaniv Z, Aylward S, Jomier J, Cleary K; "The Image-Guided Surgery Toolkit IGSTK: An Open Source C++ Software Toolkit.," Journal of Digital Imaging. 2007 Aug 17, DOI 10.1007/s10278-007-9054-3.
3. Cleary, Kevin; Insight Software Consortium; IGSTK: The Book, for release 2.0, February 2007, available by request.

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