CBCT‐based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi‐rigid organ approximation and electromagnetic tracking of the liver.
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| Title: | CBCT‐based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi‐rigid organ approximation and electromagnetic tracking of the liver. |
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| Authors: | Ivashchenko, Oleksandra V.1 (AUTHOR) o.ivashchenko@lumc.nl, Kuhlmann, Koert F.D.1 (AUTHOR), Veen, Ruben1 (AUTHOR), Pouw, Bas1 (AUTHOR), Kok, Niels F. M.1 (AUTHOR), Hoetjes, Nikie J.1 (AUTHOR), Smit, Jasper N.1 (AUTHOR), Klompenhouwer, Elisabeth G.2 (AUTHOR), Nijkamp, Jasper1 (AUTHOR), Ruers, Theodoor J. M.1,3 (AUTHOR) t.ruers@nki.nl |
| Source: | Medical Physics. May2021, Vol. 48 Issue 5, p2145-2159. 15p. |
| Subjects: | Liver surgery, Surgery, Artificial satellite tracking, Liver, Surgical instruments, Liver tumors, Ultrasonic imaging |
| Abstract: | Purpose: The surgical navigation system that provides guidance throughout the surgery can facilitate safer and more radical liver resections, but such a system should also be able to handle organ motion. This work investigates the accuracy of intraoperative surgical guidance during open liver resection, with a semi‐rigid organ approximation and electromagnetic tracking of the target area. Methods: The suggested navigation technique incorporates a preoperative 3D liver model based on diagnostic 4D MRI scan, intraoperative contrast‐enhanced CBCT imaging and electromagnetic (EM) tracking of the liver surface, as well as surgical instruments, by means of six degrees‐of‐freedom micro‐EM sensors. Results: The system was evaluated during surgeries with 35 patients and resulted in an accurate and intuitive real‐time visualization of liver anatomy and tumor's location, confirmed by intraoperative checks on visible anatomical landmarks. Based on accuracy measurements verified by intraoperative CBCT, the system's average accuracy was 4.0 ± 3.0 mm, while the total surgical delay due to navigation stayed below 20 min. Conclusions: The electromagnetic navigation system for open liver surgery developed in this work allows for accurate localization of liver lesions and critical anatomical structures surrounding the resection area, even when the liver was manipulated. However, further clinically integrating the method requires shortening the guidance‐related surgical delay, which can be achieved by shifting to faster intraoperative imaging like ultrasound. Our approach is adaptable to navigation on other mobile and deformable organs, and therefore may benefit various clinical applications. [ABSTRACT FROM AUTHOR] |
| Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Header | DbId: egs DbLabel: Engineering Source An: 150428015 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: CBCT‐based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi‐rigid organ approximation and electromagnetic tracking of the liver. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Ivashchenko%2C+Oleksandra+V%2E%22">Ivashchenko, Oleksandra V.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> o.ivashchenko@lumc.nl</i><br /><searchLink fieldCode="AR" term="%22Kuhlmann%2C+Koert+F%2ED%2E%22">Kuhlmann, Koert F.D.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Veen%2C+Ruben%22">Veen, Ruben</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pouw%2C+Bas%22">Pouw, Bas</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kok%2C+Niels+F%2E+M%2E%22">Kok, Niels F. M.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hoetjes%2C+Nikie+J%2E%22">Hoetjes, Nikie J.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Smit%2C+Jasper+N%2E%22">Smit, Jasper N.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Klompenhouwer%2C+Elisabeth+G%2E%22">Klompenhouwer, Elisabeth G.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nijkamp%2C+Jasper%22">Nijkamp, Jasper</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ruers%2C+Theodoor+J%2E+M%2E%22">Ruers, Theodoor J. M.</searchLink><relatesTo>1,3</relatesTo> (AUTHOR)<i> t.ruers@nki.nl</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Medical+Physics%22">Medical Physics</searchLink>. May2021, Vol. 48 Issue 5, p2145-2159. 15p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Liver+surgery%22">Liver surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Artificial+satellite+tracking%22">Artificial satellite tracking</searchLink><br /><searchLink fieldCode="DE" term="%22Liver%22">Liver</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+instruments%22">Surgical instruments</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+tumors%22">Liver tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Ultrasonic+imaging%22">Ultrasonic imaging</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Purpose: The surgical navigation system that provides guidance throughout the surgery can facilitate safer and more radical liver resections, but such a system should also be able to handle organ motion. This work investigates the accuracy of intraoperative surgical guidance during open liver resection, with a semi‐rigid organ approximation and electromagnetic tracking of the target area. Methods: The suggested navigation technique incorporates a preoperative 3D liver model based on diagnostic 4D MRI scan, intraoperative contrast‐enhanced CBCT imaging and electromagnetic (EM) tracking of the liver surface, as well as surgical instruments, by means of six degrees‐of‐freedom micro‐EM sensors. Results: The system was evaluated during surgeries with 35 patients and resulted in an accurate and intuitive real‐time visualization of liver anatomy and tumor's location, confirmed by intraoperative checks on visible anatomical landmarks. Based on accuracy measurements verified by intraoperative CBCT, the system's average accuracy was 4.0 ± 3.0 mm, while the total surgical delay due to navigation stayed below 20 min. Conclusions: The electromagnetic navigation system for open liver surgery developed in this work allows for accurate localization of liver lesions and critical anatomical structures surrounding the resection area, even when the liver was manipulated. However, further clinically integrating the method requires shortening the guidance‐related surgical delay, which can be achieved by shifting to faster intraoperative imaging like ultrasound. Our approach is adaptable to navigation on other mobile and deformable organs, and therefore may benefit various clinical applications. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=150428015 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1002/mp.14825 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 15 StartPage: 2145 Subjects: – SubjectFull: Liver surgery Type: general – SubjectFull: Surgery Type: general – SubjectFull: Artificial satellite tracking Type: general – SubjectFull: Liver Type: general – SubjectFull: Surgical instruments Type: general – SubjectFull: Liver tumors Type: general – SubjectFull: Ultrasonic imaging Type: general Titles: – TitleFull: CBCT‐based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi‐rigid organ approximation and electromagnetic tracking of the liver. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Ivashchenko, Oleksandra V. – PersonEntity: Name: NameFull: Kuhlmann, Koert F.D. – PersonEntity: Name: NameFull: Veen, Ruben – PersonEntity: Name: NameFull: Pouw, Bas – PersonEntity: Name: NameFull: Kok, Niels F. M. – PersonEntity: Name: NameFull: Hoetjes, Nikie J. – PersonEntity: Name: NameFull: Smit, Jasper N. – PersonEntity: Name: NameFull: Klompenhouwer, Elisabeth G. – PersonEntity: Name: NameFull: Nijkamp, Jasper – PersonEntity: Name: NameFull: Ruers, Theodoor J. M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2021 Type: published Y: 2021 Identifiers: – Type: issn-print Value: 00942405 Numbering: – Type: volume Value: 48 – Type: issue Value: 5 Titles: – TitleFull: Medical Physics Type: main |
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