Deformation Corrected Image Guided Laparoscopic Liver Surgery

变形校正图像引导腹腔镜肝脏手术

• 批准号: 10300395
• 负责人: WILLIAM Robert JARNAGIN
• 金额: $ 3.72万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-16 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10300395
• 关键词: Ablation; Alcohols; Anatomy; Area; Cancer Control; Cessation of life; Computer Models; Computer software; Data; Deposition; Diabetes Mellitus; Disease; Disease Management; Dose; Fatty Liver; Fatty acid glycerol esters; Feasibility Studies; Goals; Healthcare; Image; Incidence; Investigation; Literature; Liver; Liver diseases; Liver neoplasms; Magnetic Resonance Imaging; Malignant neoplasm of liver; Modeling; Obesity; Operative Surgical Procedures; Outcome; Patients; Physics; Primary Malignant Neoplasm of Liver; Primary carcinoma of the liver cells; Procedures; Recording of previous events; Recurrence; Salvelinus; Shapes; System; Thermal Ablation Therapy; Time; Tissues; Transplantation; Viral; Work; image guided; improved; microwave ablation; microwave electromagnetic radiation; minimally invasive; perfusion imaging

Summary Hepatic tumors represent a major health care problem in the U.S. and worldwide. In 2020, there is an estimated 42,810 new cases of primary liver cancer in U.S. with over 30,160 related deaths (worldwide, this is 20 fold greater). In addition, primary liver cancer has tripled in the U.S. since 1980 and has risen 3% each year from 2006-2015. Much of this rise has been attributed to obesity, diabetes, and fatty liver disease (FLD), which are rapidly replacing viral- and alcohol-related liver disease as a major factor of hepatocellular carcinoma (HCC). Due to limited surgical candidacy, and lack of transplant availability, locoregional therapies for the management of disease and as a bridge-to-transplant are a highly engaged area of investigation. One locoregional therapy in particular, thermal ablation, has a long history in local liver cancer control in both percutaneous procedures and within surgery. Among thermal therapies for liver, microwave ablation (MWA) is rapidly becoming a favored treatment. MWA has the advantage of creating a large spatial extent of power deposition, can penetrate through charred tissues, and has the capacity to ablate up to and around large vessels. However, common to locoregional therapies, ablation volumes can be difficult to predict for any given patient, i.e. commercial guidance information is quite generic, and recurrence and complications are still problems. The basic scientific premise underpinning this application is that improving microwave ablation (MWA) therapy is intrinsically dependent on the precise localization and determination of dose extent in relation to spatially-encoded disease and anatomic information. The overall hypothesis that the candidate will pursue is that quantitative magnetic resonance (MR) imaging can be used to create both anatomically and materially subject-specific computational models such that accurate microwave probe ablation thermal dosing can be forecast to improve ablation outcomes. The primary aim will be to create a multi-physics modeling capability to appropriately plan and forecast a patient-specific thermal ablative dose. In this aim, we propose three tasks to be accomplished: (1) develop and achieve software goals for microwave ablation modeling and planning, (2) using fat quantification data from the literature to estimate the influence that FLD could have on dose prediction, and (3) begin a feasibility study to demonstrate improved thermal dose prediction as driven by pre-procedural imaging (fat quantification, and perfusion imaging). If fully realized, this work could profoundly shape the planning, delivery, and control of microwave ablative therapy. The image-data-driven approach would allow for pre-procedural patient-specific ablation plans, intra-procedurally enable enhanced localization, and the prediction/adjustment of MWA thermal dose extent.

总结 肝肿瘤是美国和世界范围内的一个主要卫生保健问题。到2020年，预计 美国有42，810例原发性肝癌新发病例，超过30，160例相关死亡（全球范围内，这是20倍） 更大）。此外，自1980年以来，美国的原发性肝癌增加了两倍，从1990年以来每年增加3%。 2006-2015.这一增长主要归因于肥胖、糖尿病和脂肪肝（FLD），这些疾病是 快速取代病毒和酒精相关的肝病作为肝细胞癌（HCC）的主要因素。 由于有限的外科候选人，缺乏移植的可用性，局部治疗的管理 疾病和作为移植的桥梁是一个高度参与的研究领域。一次局部治疗 特别是热消融在两种经皮手术中局部肝癌控制中具有悠久历史 在手术中。在肝脏的热疗法中，微波消融（MWA）正迅速成为一种受欢迎的治疗方法。 治疗MWA具有形成大空间范围的功率沉积的优点，可以穿透 烧焦的组织，并具有消融大血管及其周围的能力。然而，共同的 局部区域治疗，对于任何给定的患者，消融体积可能难以预测，即商业指导 信息相当普遍，复发和并发症仍然是问题。基本的科学前提 支持这一应用的是，改进微波消融（MWA）治疗本质上取决于 精确定位和确定与空间编码疾病有关的剂量范围， 解剖信息候选人将追求的总体假设是， 磁共振（MR）成像可以用于创建解剖学上和材料上的对象特异性计算成像。 模型，以便可以预测准确的微波探头消融热剂量，以改善消融 结果。主要目标是创建多物理场建模能力，以适当地规划和 预测患者特定的热消融剂量。为此，我们提出了三项任务：（1） 开发并实现微波消融建模和计划的软件目标，（2）使用脂肪定量 从文献中的数据来估计FLD可能对剂量预测的影响，以及（3）开始 可行性研究，以证明由术前成像（脂肪）驱动的改进的热剂量预测 定量和灌注成像）。如果得到充分实现，这项工作将深刻影响联合国的规划、交付， 和微波消融治疗的控制。图像数据驱动的方法将允许术前 患者特异性消融计划，术中能够增强定位，并预测/调整 MWA热剂量范围。