Interventional PhotoAcoustic Surgical System (i-PASS)

描述（由申请人提供）：本项目将开发新型光声超声成像技术，以实现术中超声（IOUS）图像与术前图像、真实的时间视频和其他数据的准确、可靠和有效融合，以协助外科医生进行微创手术和其他介入手术。超声为术中使用提供了许多优势，并且在开放和腹腔镜手术中使用IOUS，为活检、肿瘤消融、近距离放射治疗和机器人手术提供指导的兴趣正在增长。 限制IOUS使用的一个重要因素是外科医生必须将超声图像中的信息与术前信息（如CT或MRI图像）以及他或她在腹腔镜视频监视器或直接可视化中看到的内容相关联。基于计算机的信息融合和可视化系统具有克服这一限制的巨大潜力，前提是它们能够1）可靠地注册IOUS 将图像与所观察到的手术场景相关联，例如，通过腹腔镜视频; 2）连续将IOUS和视频配准到术前数据;以及3）跟踪IOUS图像中的手术工具。通常依赖于光学或电磁（EM）导航跟踪器的当前系统具有若干限制，包括1）系统复杂性; 2）精度限制; 3）视线限制; 4）手术野中存在额外的线。 我们对该R21可行性项目的具体目标如下：目标1：IOUS和视频图像的实时融合：开发和评估创新的光声方法，用于术中US与视频摄像机坐标系的实时、连续配准。目标二：配准术前数据的实时跟踪：演示和评价在IOUS和摄像机坐标中配准术前模型的实时、连续跟踪和显示。目标3：IOUS中填隙工具的实时识别和跟踪：开发用于在填隙工具上生成PA信号的照明和处理方法。演示并评价这些方法用于定位实体器官肿瘤射频消融中使用的典型探头的微小尖齿。 我们的基本假设是，这些限制中的许多可以通过术中光声（PA）成像方法的新应用来克服，以允许在超声图像中的基准点的直接、实时定位。在PA成像中，激光的短脉冲被转换成可以在超声图像中检测到的声学信号。如果将多个激光光斑投射到器官表面上，则可以在视频和超声中定位它们，从而允许IOUS到相机坐标的直接配准。类似地，PA成像可用于定位组织内的小的嵌入标记，以允许相对于IOUS实时跟踪配准的术前图像和模型。它还可用于定位间质手术工具和探头上的点，从而允许相对于IOUS进行直接配准和跟踪。我们将评估在人工和离体幻影和在一个小的体内试点研究中开发的技术。

DESCRIPTION (provided by applicant): This project will develop novel photoacoustic ultrasound imaging techniques to enable accurate, reliable, and efficient fusion of intraoperative ultrasound (IOUS) images with preoperative images, real time video, and other data to assist surgeons in minimally invasive surgery and other interventional procedures. Ultrasound provides many advantages for intraoperative use, and interest in using IOUS in both open and laparoscopic surgery, in providing guidance for biopsies, tumor ablation, brachytherapy, and robotic surgery is growing. One significant factor limiting the use of IOUS is the necessity for the surgeon to relate the information in the ultrasound images to preoperative information such as CT or MRI images and to what he or she is seeing in a laparoscopic video monitor or in direct visualization. Computer-based information fusion and visualization systems have significant potential to overcome this limitation, provided that they can 1) reliably register IOUS images to the surgical scene as observed, e.g., by laparoscopic video; 2) continuously register IOUS and video to preoperative data; and 3) track surgical tools in IOUS images. Current systems typically relying on optical or electromagnetic (EM) navigational trackers have several limitations, including 1) system complexity; 2) accuracy limitations; 3) line-of-sight restrictionsor the presence of extra wires in the surgical field. Our specific aims for this R21 feasibility projct are as follows: Aim 1: Real-time fusion of IOUS and video images: Develop and evaluate innovative photoacoustic methods for real-time, continuous registration of intraoperative US to video camera coordinate systems. Aim 2: Real-time tracking of registered preoperative data: Demonstrate and evaluate real-time, continuous tracking and display of registered preoperative models in IOUS and video camera coordinates. Aim 3: Real-time identification and tracking of interstitial tools in IOUS: Develop illumination and processing methods for generating PA signals on interstitial tools. Demonstrate and evaluate the use of these methods for locating the tiny tines of a typical probe used in RF ablation of tumors in solid organs. Our basic hypothesis is that many of these limitations can be overcome by the novel application of intraoperative photoacoustic (PA) imaging methods to permit direct, real-time localization of fiducial points in ultrasound images. In PA imaging, short pulses of laser light are converted into acoustic signals that can be detected in ultrasound images. If multiple laser spots are projected onto an organ surface, they may be located both in video and in ultrasound, thus permitting direct registration of IOUS-to-camera coordinates. Similarly, PA imaging may be used to locate small, embedded markers inside tissue to permit real-time tracking of registered preoperative images and models relative to IOUS. And it may be used to locate points on interstitial surgical tools and probes, thus permitting direct registration and tracking relative to IOUS. We will evaluate the technology developed in artificial & ex vivo phantoms and in a small in vivo pilot study.