Real-time fiber selection using the Wii remote

In the last few years, fiber tracking tools have become popular in clinical contexts, e.g., for pre- and intraoperative neurosurgical planning. The efficient, intuitive, and reproducible selection of fiber bundles still constitutes one of the main issues. In this paper, we present a framework for a real-time selection of axonal fiber bundles using a Wii remote control, a wireless controller for Nintendo's gaming console. It enables the user to select fiber bundles without any other input devices. To achieve a smooth interaction, we propose a novel spacepartitioning data structure for efficient 3D range queries in a data set consisting of precomputed fibers. The data structure which is adapted to the special geometry of fiber tracts allows for queries that are many times faster compared with previous state-of-the-art approaches. In order to extract reliably fibers for further processing, e.g., for quantification purposes or comparisons with preoperatively tracked fibers, we developed an expectationmaximization clustering algorithm that can refine the range queries. Our initial experiments have shown that white matter fiber bundles can be reliably selected within a few seconds by the Wii, which has been placed in a sterile plastic bag to simulate usage under surgical conditions.