Feasibility of Navigated Resection of Liver Tumors Using Multiplanar Visualization of Intraoperative 3-dimensional Ultrasound Data
| Autor: | Peter M. Schlag, Thomas Lange, Siegfried Beller, Michael Hünerbein, Sebastian Eulenstein |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Target lesion medicine.medical_specialty medicine.medical_treatment Resection Imaging Three-Dimensional Monitoring Intraoperative medicine Hepatectomy Humans 3D ultrasound Prospective Studies Aged Ultrasonography medicine.diagnostic_test business.industry Liver Neoplasms Ultrasound Reproducibility of Results Magnetic resonance imaging Original Articles Middle Aged Visualization Liver biopsy Feasibility Studies Female Surgery Radiology business Follow-Up Studies |
| Zdroj: | Annals of Surgery. 246:288-294 |
| ISSN: | 0003-4932 |
| DOI: | 10.1097/01.sla.0000264233.48306.99 |
| Popis: | Liver resection has become increasingly safe as a result of considerable progress in equipment, technology, perioperative management, and surgical technique.1 Intraoperative identification of the vascular tree, ie, hepatic and portal veins and the localization of the tumor remains essential for segment oriented surgical resection. Preoperative 3-dimensional (3D) imaging techniques using computed tomography (CT) or magnetic resonance imaging (MRI) data offer perfect visualization of the anatomy.2 However, 3D simulation models are mainly used for preoperative planning. Anatomic information cannot be transferred to the intraoperative situation directly, due to organ shift and deformation of the liver during mobilization for resection.3 The most frequently used intraoperative imaging technique is ultrasound. It is generally available, and its diagnostic quality is continuously improving. The main objectives of intraoperative ultrasound during liver surgery are to determine tumor resectability, to localize nonpalpable tumors, and to guide surgical procedures.4 Intraoperative imaging is particularly useful for resection of malignant liver lesions,5 but at this time it is mainly used to detect additional metastases. Two-dimensional ultrasound is mostly displayed on a monoscopic video monitor. Advanced 3D and four-dimensional visualization for guidance of interventional procedures has been only realized in tumor ablation and liver biopsy procedures.6,7 The spatial relationship of the needle and the target lesion was conceived more intuitively with 3D and four-dimensional ultrasonography and helped in adjusting the needle to an optimal position. We have integrated 3D ultrasound and optoelectronic tracking into a strategy of navigated liver resection. Optoelectronic tracking was used for this study. Accuracy and precision of the system were first validated in a tumor model in an experimental setup. Then a clinical study was performed to evaluate feasibility, basic requirements of 3D ultrasound visualization, performance, and resection margins in relation to the surgical plan. |
| Databáze: | OpenAIRE |
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