Interventional PhotoAcoustic Surgical System (i-PASS)

描述(申请人提供)：该项目将开发新的光声超声成像技术，以实现术中超声(IOUS)图像与术前图像、实时视频和其他数据的准确、可靠和有效的融合，以帮助外科医生进行微创手术和其他介入手术。超声为术中的使用提供了许多优势，在开腹和腹腔镜手术中使用IOU，在为活检、肿瘤消融、近距离放射治疗和机器人手术提供指导方面的兴趣正在增长。限制IOU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所看到的信息相关联。基于计算机的信息融合和可视化系统有很大的潜力来克服这一限制，前提是它们能够可靠地登记欠条 将图像记录到例如通过腹腔镜视频观察到的手术场景；2)将IOU和视频连续记录到术前数据；以及3)在IOU图像中跟踪手术工具。目前通常依赖光学或电磁(EM)导航跟踪器的系统有几个限制，包括1)系统复杂性；2)精度限制；3)视线限制或外科领域中存在额外的电线。我们对R21可行性项目的具体目标如下：目标1：IOU和视频图像的实时融合：开发和评估术中US与摄像机坐标系实时、连续配准的创新光声方法。目的2：实时跟踪登记的术前数据：演示和评估在IOU和摄像机坐标下实时、连续地跟踪和显示登记的术前模型。目标3：IOU中间质工具的实时识别和跟踪：开发在间质工具上产生PA信号的照明和处理方法。演示和评估这些方法的使用，以定位用于射频消融实体器官肿瘤的典型探头的微小尖牙。我们的基本假设是，许多这些限制可以通过术中光声成像(PA)方法的新应用来克服，从而允许直接、实时地定位超声图像中的基准点。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。如果多个激光斑点被投射到器官表面，它们可能同时位于视频和超声中，从而允许直接配准IOU与相机的坐标。类似地，PA成像可以用来定位组织内嵌入的小标记，以允许实时跟踪与IOU相关的注册的术前图像和模型。它可以用来定位间质手术工具和探头上的点，从而允许相对于IOU的直接注册和跟踪。我们将评估在人工和体外模体中开发的技术，以及在体内的小型先导研究。

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.