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The Periscopic Spine Surgery project was envisioned to lay the ground work for developing the physician assist systems of the future. These systems will incorporate robotics, tracking, and visualization to improve the precision of instrument placement and manipulation in minimally invasive procedures. This project has enabled the Georgetown team to become a world leader in the emerging fields of computer aided surgery and medical robotics. Our goal will continue to be to develop systems to add the physician in these demanding minimally invasive procedures with the ultimate aim of improving patient care. Key research accomplishments included: 1. Investigated methods for slice to volume registration of CT fluoroscopy images to provide image guidance for lung biopsy. 2. Completed an approved swine study in the CT procedure room demonstrating the feasibility of electromagnetic position sensing for image guidance. 3. Completed an initial accuracy study of electromagnetic position sensing in the CyberKnife suite and showed that relatively good accuracy could be obtained even with the LINAC (radiation beam) turned on. 4. Developed the software architecture and software implementation for an open source image-guided surgery toolkit. 5. Completed an initial study of workflow in the interventional suite for spinal nerve blocks.