Developing a Computerized Training Tool for Cryosurgery

描述（由申请人提供）：冷冻手术是通过冷冻来破坏不需要的组织。尽管微创冷冻手术的设备和技术不断发展，但现代冷冻手术往往不能最大限度地对靶区进行冷冻破坏，同时最大限度地减少对周围组织的冷冻损伤。在这里，最重要的困难之一——可能是不太直观的障碍——是设计和生成一个与目标区域的形状充分相关的冷冻区域，并建立冷冻手术成功的标准。该项目侧重于与规划和创建冷冻手术最佳3D热场相关的医学培训和教育，以造福外科医生、医学研究人员和临床仪器开发人员。

DESCRIPTION (provided by applicant): Cryosurgery is the destruction of undesired tissues by freezing. Despite the continuous development of devices and techniques for minimally invasive cryosurgery, modern cryosurgery frequently falls short of maximizing cryodestruction to the target region, while minimizing cryoinjury to the surrounding tissues. Here, one of the most significant difficulties - and probably the less intuitive obstacle to overcome - is the design and generation of a frozen region to adequately correlate with the shape of the target region and established criteria for cryosurgery success. This project focuses on medical training and education associated with planning and creation of the optimal 3D thermal field for cryosurgery, for the benefit of the surgeon, the medical researcher, and the clinical instrumentation developer. A computerized training tool is developed in this project, the objectives being to shorten the clinician's learning curve, reduce practice time, enable case studies of "what-if" scenarios, and to enable revaluation of past clinical procedures via a cryosurgery database. While the training tool is designed for general purposes, due to its high clinical relevancy, a particular attention is given to prostate cryosurgery. The training tool consists of three modules: database, simulator, and tutor; the development of each represents one specific aim of the overall research plan. The database consists of three types of datasets: (i) volumetric images obtained from an imaging device such as ultrasound, (ii) reconstructed 3D target region models, and (iii) surgical- procedure outcomes, subject to specific surgical parameters such as number and type of cryoprobes, cryoprobe layout, cryoprobe freezing capabilities, and the resulting temperature field history. The simulator imitates the bioheat transfer process and its imaging with a standard ultrasound technique. Based on the simulated process, the tutor interactively guides the trainee to identify the optimal cryoprobes layout. The tutor may be used for planning future procedures or reevaluation of past cases, while further increasing the size of the database. Consistent with NIH Program Announcement (PA) PAR-07-344 - in the specific area of "Surgery and Virtual Tools"- this project integrates computational techniques for simulation of the surgical procedure, including the imaging effects unique to freezing, and predictions of the bioheat transfer process in the clinically treated area. Emphasis is placed on cryosurgery database design, data retrieval, visualization and graphical interfaces, where the database includes imaging data, geometrical modeling of the target region, cryodevice characteristics, and thermal field history. This project utilizes rapid simulation techniques for bioheat transfer, and recently developed algorithms for computerized planning of cryosurgery. The broader impact of this training tool can potentially far exceed its specific application to cryosurgery, by applying similar methodology to other thermal modalities in surgery, such as focused ultrasound, microwave, laser probes, and other multi-source heating elements.