Design and implementation of an integrated navigation system basedon intraoperative nuclear probes for open and minimally invasive surgey

以色列科学研究院核医学系和明兴理工大学信息学学院计算机辅助医疗程序主席的这一联合研究项目的目的是调查、设计和实施新的集成导航程序，使能够在手术室中进行手持功能成像，例如用于前哨淋巴结检测、恶性肿瘤定位和肿瘤的完全但微小的切除。手持核探测器的一维信号将与6D位置和定向定位系统相结合，以创建能够重建3D放射性分布的表面或提供功能体积信息的功能成像探测器。因此，使用了三种不同的探测器来测量贝塔、低能和高能伽马活动。β探头测量肿瘤示踪剂在非常接近表面的地方的活性，从而控制切除边界。伽马探头测量源自组织深处的伽马辐射，从而定位癌症示踪剂(高能探头)以及前哨淋巴结示踪剂(低能探头)。所有可用的信息，例如术前获取和注册的SPECT/CT和PET/CT数据、生物特征数据等的组合，将以一种复杂的方式进一步合并到一个综合导航解决方案中，用于在手术中定位和切除肿瘤和前哨淋巴结。集成的流程、用户界面和可视化将设计用于开放和微创手术，如内窥镜和腹腔镜干预。

The aim of this joint research program between the Nuclear Medicine Department of the Klinikum rechts der Isar and the Chair for Computer Aided Medical Procedures at the Informatics faculty of the Technische Universität München is to investigate, design, and implement new integrated navigated procedures enabling handheld functional imaging in the operation room e.g. for sentinel lymph node detection, malignant tumor localization, and complete but minimal resection of tumors. The one dimensional signal of handheld nuclear probes will be combined with a 6D position and orientation localization system in order to create functional imaging probes that are capable to reconstruct a surface of a radioactivity distribution in 3D or provide functional volume information. Therefore, three different probes measuring beta, low and high energy gamma activity are used. Beta probes measure activity of tumor tracers in a very close vicinity to the surface allowing thus the control of resection border. Gamma probes measure gamma radiation that originates deep inside tissue allowing localization of cancer tracers (high energy probes) as well as tracers for sentinel lymph nodes (low energy probes). The combination of all available information e.g. preoperative acquired and registered SPECT/CT and PET/CT data, biometric data, etc. will be incorporated further in a sophisticated way in an integrated navigation solution for localization and resection of tumor and sentinel lymph nodes during surgery. The integrated process, user interface, and visualization will be designed for open and minimal invasive procedure, such as endoscopic and laparoscopic interventions.