3D LIVER IMAGING FOR ONCOLOGIC SURGERY PLANNING

用于肿瘤手术计划的 3D 肝脏成像

• 批准号: 3200147
• 负责人: Elliot Keith Fishman
• 金额: $ 33.07万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-08-01 至 1995-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3200147
• 关键词: computed axial tomography; diagnosis quality /standard; human subject; imaging /visualization /scanning; liver circulation; liver disorder diagnosis; metastasis; neoplasm /cancer surgery; prognosis; technology /technique development

Current treatment for colorectal cancer with hepatic involvement, as well as for primary hepatocellular carcinoma, is hepatic resection. New surgical resection schemes have significantly improved the cure rates attained by hepatic resection, yet, the procedure continues to be limited, in part, by the ability of the surgeon to comprehend, in 3D, the location and extent of tumor with respect to liver anatomy. Detection of lesions is by radiological imaging techniques, with computed tomography (CT) with intra-arterial injection the current gold standard. Conventional display of transaxial CT data doesn't fully address the surgeon's needs. The ultimate objective of an imaging system for surgical planning is realistic simulation of the surgical procedure. One can imagine, some decades from now, a system in which a holographic 3D image of the patient floats in front of the surgeon who, with electronic analogs of surgical instruments, can perform the entire procedure in advance of any actual surgery. Developments in computer science and image processing lead towards this ultimate objective. Manipulation of image data into a 3D model is the impetus for development of techniques that can help accurately determine operative resectability and provide a road map for that surgery. 3D imaging has been applied to orthopedic applications, but has not been routinely used to image the liver. Although surgical techniques in orthopedics differ from those used for the liver, the overall visualization of the clinical situation in 3D is shared in both applications, and motivates our use of 3D imaging for the liver. The final goal is to develop methods for imaging the liver that will aid the surgeon in determining resectability and planning an operative approach to resection which both increases the accuracy of selection of patients who are resectable and improves the outcome in those who undergo surgical resection. In order to achieve this goal, 4 specific aims have been identified: (1) To refine acquisition techniques which optimize detection and anatomical definition of the normal liver, tumor, and hepatic vascularity for use in the construction of 3D images, (2) to develop algorithms for segmentation of liver anatomy and pathology from CT data, (3) to create an imaging system using 2D and 3D images for surgical planning for the surgeon, oncologist and radiologist, (4) to evaluate the effectiveness of the imaging system by a pilot study of the techniques in potential candidates for surgical liver resection. Achieving these aims will combine helical CT scanning, probabilistic segmentation, the volumetric rendering technique, and advanced real time imaging. Approximately 20 patients with primary hepatocellular carcinoma or metastases scheduled for liver resection will be used to evaluate and refine the techniques. It is the goal of this project to provide optimal care for these patients by combining state of the art radiologic imaging and surgical technique with advanced computer imaging.

目前对肝脏受累的结直肠癌的治疗， 以及原发性肝细胞癌的治疗方法是肝切除术。 新 手术切除方案显著提高了治愈率 通过肝切除获得，然而，该程序仍然是 部分受限于外科医生理解的能力，在3D中， 肿瘤相对于肝脏解剖结构的位置和范围。 通过放射成像技术检测病变， 计算机断层扫描（CT）与动脉内注射电流金 标准 传统的经轴CT数据显示不完全， 满足外科医生的需求。 成像的最终目的 用于手术规划的系统是手术的真实模拟， procedure. 人们可以想象，几十年后，一个系统， 患者的全息3D图像漂浮在外科医生面前， 与手术器械的电子模拟物，可以执行整个 在任何实际手术之前进行手术。 计算机的发展 科学和图像处理导致这一最终目标。 将图像数据处理成3D模型是 发展技术，可以帮助准确地确定手术 并为手术提供路线图。 3D成像具有 已应用于骨科应用，但尚未常规使用 对肝脏进行成像 虽然骨科的手术技术不同 从那些用于肝脏，临床的整体可视化 3D的情况在两个应用程序中是共享的，并激励我们使用 肝脏的3D成像 最终目标是开发方法， 对肝脏进行成像，以帮助外科医生确定可切除性 并计划一个手术切除的方法，既增加了 选择可切除患者的准确性， 在那些接受手术切除的患者中， 为了实现 为此，确定了4个具体目标：（1）完善 采集技术，优化检测和解剖 正常肝脏、肿瘤和肝血管分布的定义 在3D图像的构建中，（2）开发算法 从CT数据分割肝脏解剖和病理，（3）创建 使用2D和3D图像进行手术计划的成像系统， 外科医生、肿瘤科医生和放射科医生，（4）评价有效性 的成像系统的潜在技术的试点研究 外科肝切除术的候选人。 实现这些目标将 联合收割机螺旋CT扫描，概率分割，容积 绘制技术和先进的真实的时间成像。 大约20 计划治疗的原发性肝细胞癌或转移瘤患者 将用于评估和改进技术。 该项目的目标是为这些患者提供最佳护理， 通过结合最先进的放射成像和外科手术 先进的计算机成像技术。