Computerized Planning of Cryosurgery: From Model Reconstruction to Cryoprobe Placement Strategies.
Computerized Planning of Cryosurgery: From Model Reconstruction to Cryoprobe Placement Strategies.
复制标题
冷冻手术的计算机化规划：从模型重建到冷冻探针放置策略。
DOI：
10.1117/12.810537
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Rabin,Yoed
中科院分区：
文献类型：
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作者：
Rabin,Yoed
作为正在进行的开发手术计算机化工具计划的一部分，目前的研究重点是为前列腺冷冻外科设计最佳冷冻探头布局。一旦做出用冷冻外科治疗前列腺的决定，它的应用可以被描述为一个四个阶段的过程：(I)靶区的三维重建；(Ii)评估最佳冷冻探头数量及其布局；(Iii)根据该计划插入冷冻探头；以及(Iv)协调冷冻探头操作，以实现靶区和形成的冰冻区域之间的最佳匹配。冷冻手术的成功等于上述每个阶段的成功之和。到目前为止，这个分为四个阶段的过程都是依靠冷冻医生的经验和“经验法则”手动完成的。本文回顾了最近为前列腺冷冻手术的集成计算机外科工具开发必要的积木的最新努力，其中包括前列腺模型重建的方法、生物传热模拟方案和冷冻探头放置的优化技术；还提供了这些积木的实验验证。这一发展路线的重点是在不到一分钟的时间内完成全面的规划，而患者则在手术台上。从目前的稿件可以得出结论，上述目标是可以实现的。目前的手稿最后回顾了相关计算机化手段发展方面目前面临的挑战。
As a part of an ongoing program to develop computerized tools for surgery, the current study focuses on the design of optimal cryoprobe layouts for prostate cryosurgery. Once a decision to treat the prostate with cryosurgery has been made, its application can be presented as a four-stage process: (i) 3D reconstruction of the target region; (ii) evaluation of the optimum number of cryoprobes and their layout; (iii) insertion of cryoprobes according to that plan; and, (iv) orchestrating cryoprobe operation to achieve the optimum match between the target region and the forming frozen region. Cryosurgical success equals the sum of the successes of each of the above stages. To date, this four-stage process is performed manually, relying upon the cryosurgeon's experience and "rules of thumb". This manuscript reviews recent efforts to develop the necessary building blocks for an integrated computerized surgical tool for prostate cryosurgery, which includes methods for prostate model reconstruction, schemes for bioheat transfer simulation, and optimization techniques for cryoprobe placement; experimental verification of these building blocks are also presented. The emphasis in this line of development is on performing a full-scale planning in less than one minute, while the patient is on the operation table. It can be concluded from the current manuscript that the above goals are achievable. The current manuscript concludes with a review of current challenges in the development of related computerized means.