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Survarachakan S, Prasad PJR, Naseem R, Pérez de Frutos J, Kumar RP, Langø T, Alaya Cheikh F, Elle OJ, Lindseth F. Deep learning for image-based liver analysis — A comprehensive review focusing on malignant lesions. Artif Intell Med 2022; 130:102331. [DOI: 10.1016/j.artmed.2022.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
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Thomas MN, Dieplinger G, Datta RR, Kleinert R, Fuchs HF, Bunck A, Peterhans M, Bruns CJ, Stippel D, Wahba R. Navigated laparoscopic microwave ablation of tumour mimics in pig livers: a randomized ex-vivo experimental trial. Surg Endosc 2021; 35:6763-6769. [PMID: 33289054 PMCID: PMC8599321 DOI: 10.1007/s00464-020-08180-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In order to efficiently perform laparoscopic microwave ablation of liver tumours precise positioning of the ablation probe is mandatory. This study evaluates the precision and ablation accuracy using the innovative laparoscopic stereotactic navigation system CAS-One-SPOT in comparison to 2d ultrasound guided laparoscopic ablation procedures. METHODS In a pig liver ablation model four surgeons, experienced (n = 2) and inexperienced (n = 2) in laparoscopic ablation procedures, were randomized for 2d ultrasound guided laparoscopic or stereotactic navigated laparoscopic ablation procedures. Each surgeon performed a total of 20 ablations. Total attempts of needle placements, time from tumor localization till beginning of ablation and ablation accuracy were analyzed. RESULTS The use of the laparoscopic stereotactic navigation system led to a significant reduction in total attempts of needle placement. The experienced group of surgeons reduced the mean number of attempts from 2.75 ± 2.291 in the 2d ultrasound guided ablation group to 1.45 ± 1.191 (p = 0.0302) attempts in the stereotactic navigation group. Comparable results could be observed in the inexperienced group with a reduction of 2.5 ± 1.50 to 1.15 ± 0.489 (p = 0.0005). This was accompanied by a significant time saving from 101.3 ± 112.1 s to 48.75 ± 27.76 s (p = 0.0491) in the experienced and 165.5 ± 98.9 s to 66.75 ± 21.96 s (p < 0.0001) in the inexperienced surgeon group. The accuracy of the ablation process was hereby not impaired as postinterventional sectioning of the ablation zone revealed. CONCLUSION The use of a stereotactic navigation system for laparoscopic microwave ablation procedures of liver tumors significantly reduces the attempts and time of predicted correct needle placement for novices and experienced surgeons without impairing the accuracy of the ablation procedure.
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Affiliation(s)
- M N Thomas
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - G Dieplinger
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R R Datta
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R Kleinert
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - H F Fuchs
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - A Bunck
- Department of Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | - C J Bruns
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - D Stippel
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R Wahba
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
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A narrative review on endopancreatic interventions: an innovative access to the pancreas. JOURNAL OF PANCREATOLOGY 2021. [DOI: 10.1097/jp9.0000000000000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Feasibility and usability of real-time intraoperative quantitative fluorescent-guided perfusion assessment during resection of gastroesophageal junction cancer. Langenbecks Arch Surg 2020; 405:215-222. [PMID: 32281020 DOI: 10.1007/s00423-020-01876-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Anastomotic leakage after resection of gastroesophageal junction cancer is a dangerous complication, and leakage rates have remained stable for decades. Perfusion is crucial for anastomotic healing, but traditional perfusion assessment is limited in a minimally invasive environment. New methods as indocyanine green fluorescence angiography (ICG-FA) have proven promising, but quantitative analysis has been challenging. This study aimed to demonstrate the feasibility and usability of real-time intraoperative quantitative fluorescence angiography (q-ICG) with a touchscreen tablet. METHODS A software for q-ICG was previously developed and validated. Ten patients underwent perfusion assessment in white light (WL), with ICG-FA, and with q-ICG during Ivor-Lewis esophageal resection. The usability of the tablet-based software was tested with the System Usability Scale (SUS®). Furthermore, we investigated the differences in perfusion assessment as the distance from the conduit margin to a surgeon selected point of sufficient perfusion for anastomosis using the different modalities. RESULTS Q-ICG was successful in all patients, with an excellent median SUS® of 82.5 (77.5-93.8). Significant differences in distances from the conduit margin to points of sufficient perfusion selected by the surgeons were found: ICG: WL = 14.1 mm (p = 0.048), q-ICG: WL = 32.08 mm (p < 0.001), and q-ICG: ICG = 17.95 mm (p = 0.002). Furthermore, significant differences of perfusion were found between the points, when q-ICG was performed retrospectively in the surgeon selected areas (p = 0.008-0.013). CONCLUSION Real-time intraoperative touchscreen-based q-ICG was feasible with excellent usability, and differences in sufficient perfusion points selected by the surgeons between modalities were found. Further studies should focus on clinical relevance and determine cutoff values associated with anastomotic leakage.
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Sakata K, Kijima T, Arai O. Initial Report: A Novel Intraoperative Navigation System for Laparoscopic Liver Resection Using Real-Time Virtual Sonography. Sci Rep 2020; 10:6174. [PMID: 32277107 PMCID: PMC7148355 DOI: 10.1038/s41598-020-63131-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
Recent progress in navigation has revealed problems involving non-rigid registration for hepatic surgery. With the increasing popularity of laparoscopic liver surgery, a new laparoscopic navigation system is necessary. This study involved an in-vitro demonstration of a 3-dimensional printer model and in vivo demonstration in four patients. For the in vitro examination, a position detecting unit attached at 33 cm and 13 cm distance conditions from the tip of the electrocautery was examined eight times at the marked points on the liver surface eight times respectively. The differences between the simulation and the authentic dissecting plane were conventionally investigated in vivo. In vitro, the errors of the 33 cm and 13 cm distance model were7.8 ± 3.5 mm (mean ± SD), and 3.3 ± 1.0 mm, respectively. The mean differences of the dissection plane were within 10 mm. The potentiality and safety of the novel navigation system was confirmed, although further investigation is recommended.
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Affiliation(s)
- Koichiro Sakata
- Japan Seafares Relief Association Ekisaikai Moji Hospital 1-3-1 Kiyotaki Mojiku Kitakyushu, Fukuoka, 801-8505, Japan. .,JCHO Shimonoseki Medical Centre, 3-3-8 kamishinchi-machi, Shimonoseki, Yamaguchi, 083-231-5811, Japan.
| | - Taiki Kijima
- JCHO Shimonoseki Medical Centre, 3-3-8 kamishinchi-machi, Shimonoseki, Yamaguchi, 083-231-5811, Japan
| | - Osamu Arai
- Hitachi, Ltd. Healthcare Business Unit, 3-1-1, Higashikoigakubo, Kokubunji-shi, Tokyo, 185-0014, Japan
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Ahmad MS, Suardi N, Shukri A, Mohammad H, Oglat AA, Alarab A, Makhamrah O. Chemical Characteristics, Motivation and Strategies in choice of Materials used as Liver Phantom: A Literature Review. J Med Ultrasound 2020; 28:7-16. [PMID: 32368444 PMCID: PMC7194418 DOI: 10.4103/jmu.jmu_4_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/26/2019] [Accepted: 05/24/2019] [Indexed: 12/27/2022] Open
Abstract
Liver phantoms have been developed as an alternative to human tissue and have been used for different purposes. In this article, the items used for liver phantoms fabrication are mentioned same as in the previous literature reviews. Summary and characteristics of these materials are presented. The main factors that need to be available in the materials used for fabrication in computed tomography, ultrasound, magnetic resonance imaging, and nuclear medicine were analyzed. Finally, the discussion focuses on some purposes and aims of the liver phantom fabrication for use in several areas such as training, diagnoses of different diseases, and treatment planning for therapeutic strategies – for example, in selective internal radiation therapy, stereotactic body radiation therapy, laser-induced thermotherapy, radiofrequency ablation, and microwave coagulation therapy. It was found that different liver substitutes can be developed to fulfill the different requirements.
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Affiliation(s)
- Muntaser S Ahmad
- Department of Medical Physics and Radiation Science, School of Physics, Universiti Sains Malaysia, Malaysia
| | - Nursakinah Suardi
- Department of Medical Physics and Radiation Science, School of Physics, Universiti Sains Malaysia, Malaysia
| | - Ahmad Shukri
- Department of Medical Physics and Radiation Science, School of Physics, Universiti Sains Malaysia, Malaysia
| | - Hjouj Mohammad
- Department of Medical Imaging, Faculty of Health Professions, Al-Quds University, Abu Deis - Main Campus, Jerusalem, Palestine
| | - Ammar A Oglat
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan, Palestine
| | - Azzam Alarab
- Department of Medical Imaging, Faculty of Allied Medical Health, Palestine Ahlyia University, Bethlehem, Palestine
| | - Osama Makhamrah
- Department of Medical Imaging, Faculty of Health Professions, Al-Quds University, Abu Deis - Main Campus, Jerusalem, Palestine
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Collins JA, Heiselman JS, Clements LW, Brown DB, Miga MI. Multiphysics modeling toward enhanced guidance in hepatic microwave ablation: a preliminary framework. J Med Imaging (Bellingham) 2019; 6:025007. [PMID: 31131291 DOI: 10.1117/1.jmi.6.2.025007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/23/2019] [Indexed: 12/14/2022] Open
Abstract
We compare a surface-driven, model-based deformation correction method to a clinically relevant rigid registration approach within the application of image-guided microwave ablation for the purpose of demonstrating improved localization and antenna placement in a deformable hepatic phantom. Furthermore, we present preliminary computational modeling of microwave ablation integrated within the navigational environment to lay the groundwork for a more comprehensive procedural planning and guidance framework. To achieve this, we employ a simple, retrospective model of microwave ablation after registration, which allows a preliminary evaluation of the combined therapeutic and navigational framework. When driving registrations with full organ surface data (i.e., as could be available in a percutaneous procedure suite), the deformation correction method improved average ablation antenna registration error by 58.9% compared to rigid registration (i.e., 2.5 ± 1.1 mm , 5.6 ± 2.3 mm of average target error for corrected and rigid registration, respectively) and on average improved volumetric overlap between the modeled and ground-truth ablation zones from 67.0 ± 11.8 % to 85.6 ± 5.0 % for rigid and corrected, respectively. Furthermore, when using sparse-surface data (i.e., as is available in an open surgical procedure), the deformation correction improved registration error by 38.3% and volumetric overlap from 64.8 ± 12.4 % to 77.1 ± 8.0 % for rigid and corrected, respectively. We demonstrate, in an initial phantom experiment, enhanced navigation in image-guided hepatic ablation procedures and identify a clear multiphysics pathway toward a more comprehensive thermal dose planning and deformation-corrected guidance framework.
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Affiliation(s)
- Jarrod A Collins
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Jon S Heiselman
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Logan W Clements
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Daniel B Brown
- Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
| | - Michael I Miga
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States.,Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, Tennessee, United States
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An open electromagnetic tracking framework applied to targeted liver tumour ablation. Int J Comput Assist Radiol Surg 2019; 14:1475-1484. [PMID: 31030387 DOI: 10.1007/s11548-019-01983-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Electromagnetic tracking is a core platform technology in the navigation and visualisation of image-guided procedures. The technology provides high tracking accuracy in non-line-of-sight environments, allowing instrument navigation in locations where optical tracking is not feasible. EMT can be beneficial in applications such as percutaneous radiofrequency ablation for the treatment of hepatic lesions where the needle tip may be obscured due to difficult liver environments (e.g subcutaneous fat or ablation artefacts). Advances in the field of EMT include novel methods of improving tracking system accuracy, precision and error compensation capabilities, though such system-level improvements cannot be readily incorporated in current therapy applications due to the 'blackbox' nature of commercial tracking solving algorithms. METHODS This paper defines a software framework to allow novel EMT designs, and improvements become part of the global design process for image-guided interventions. An exemplary framework is implemented in the Python programming language and demonstrated with the open-source Anser EMT system. The framework is applied in the preclinical setting though targeted liver ablation therapy on an animal model. RESULTS The developed framework was tested with the Anser EMT electromagnetic tracking platform. Liver tumour targeting was performed using the tracking framework with the CustusX navigation platform using commercially available electromagnetically tracked needles. Ablation of two tumours was performed with a commercially available ablation system. Necropsy of the tumours indicated ablations within 5 mm of the tumours. CONCLUSIONS An open-source framework for electromagnetic tracking was presented and effectively demonstrated in the preclinical setting. We believe that this framework provides a structure for future advancement in EMT system in and customised instrument design.
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