TRD 3 - Enabling Technologies for Intraprocedural Guidance

摘要 随着个性化医疗的最新进展，人们越来越多地认识到 图像引导的干预措施。在进行图像引导之前，必须解决两个关键需求 介入在精确医学中发挥着关键作用-成像作为一种成功的应用 治疗效果的预测生物标记物以及用于识别、采样和 监视目标组织。目标是通过协同作用开发一套术中装置 技术和生物医学专业知识的互动，并提供原型软件工具/设备 由3D Slicer启用。目的1术中针导引前列腺活检和消融术 我们会 创建、测试和验证图像引导软件，以解决针头偏转问题，并提供 核磁共振引导下前列腺癌穿刺术的最佳插入路径。这一目标将 提供一整套工具，即具有精细网格图案和引导的经会阴模板 考虑到针头偏转的软件。目标2.术中发展一种 肺部手术的可视化和导航。我们将开发以增强现实(AR)为导向的 腹腔镜肺手术导航系统将与新型计算机视觉和 用于补偿肺部变形的机器学习算法。我们还将开发机器- 基于学习的特征描述子精确跟踪立体腹腔镜解剖特征 图像。目标3：集成检索的植入式微型装置的技术开发 机制。我们将开发新的可植入微设备(IMD)原型，这些原型已经集成 对于难以接近的组织，如大脑--在局灶性肿瘤内--的可恢复性，每个IMD包含 多达20个单独的井用于安装毒品。我们将使用图像引导来实现最佳位置- 在肿瘤中，允许这些药物的焦点和受控释放，然后图像引导装置 检索(删除)。一旦图像引导取回IMD被用组织的“袖带”或边缘移除， 这将接受病理分析，以发现是否存在足够数量的组织，然后 局部组织/肿瘤反应分析。合作项目将受益于 在TRD3中实现了经过临床测试的新型设备和相关软件。

ABSTRACT Recent advances in personalized medicine have been accompanied by increasing recognition of image-guided interventions. Two critical needs have to be addressed before image-guided intervention plays a key role in precision medicine – the successful application of imaging as a predictive biomarker of therapeutic efficacy and the development of devices to identify, sample, and monitor target tissues. The goal is to develop a set of intraoperative devices through synergistic interactions of technical and biomedical expertise and deliver prototypic software tools/devices enabled by 3D Slicer. Aim 1 Intraoperative needle guidance for prostate biopsy and ablation We will create, test, and validate image-guidance software to address needle deflection and provide an optimal insertion path for in-bore MRI-guided biopsy and ablation of prostate cancer. This aim will deliver a complete set of tools namely-a transperineal template with fine grid pattern and guidance software that takes into account needle deflection. Aim 2. Development of an intraoperative visualization and navigation for lung surgery. We will develop an augmented reality (AR)-guided navigation system for laparoscopic lung surgery to be integrated with novel computer vision and machine learning algorithms to compensate for lung deformation. We will also develop machine- learning based feature descriptors to accurately track anatomical features from stereo laparoscopic images. Aim 3: Technical development of an implantable microdevice with integrated retrieval mechanism. We will develop new implantable microdevice (IMD) prototypes that have integrated retrievability for difficult to access tissues such as the brain-within a focal tumor -each IMD contains up to 20 individual wells for installation of drugs. We will use image guidance for optimal placement - in the tumor, to allow focal and controlled release of these drugs and then image guided device retrieval (removal). Once the image guided retrieval the IMD is removed with a “cuff” or rim of tissue, this will undergo pathological analysis to discover if an adequate amount of tissue is present and then analyzes of local tissue/tumor response. Collaborating projects will be benefitted by incorporating novel and clinically tested devices and associated software made possible in the TRD 3.