Enhanced tumour localization, visualization, resection and radiotherapy in computer-aided surgery: Assisting surgeons via robotics and augmented-reality image-overlay technologies

增强计算机辅助手术中的肿瘤定位、可视化、切除和放射治疗：通过机器人和增强现实图像叠加技术协助外科医生

• 批准号: 571022-2021
• 负责人: TavakoliAfshari, SeyedMahdiSM
• 金额: $ 3.64万
• 依托单位: University of Alberta
• 依托单位国家: 加拿大
• 项目类别: Alliance Grants
• 财政年份: 2022
• 资助国家: 加拿大
• 起止时间: 2022-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=751975
• 关键词: Enhanced; tumour; localization; visualization; resection

For early-stage breast cancer, treatment options include mastectomy in which the breast is fully removed and lumpectomy (breast-conserving surgery) in which only the tumour and a portion of the adjacent tissue are removed. Lumpectomy is often preferred by women for a number of factors including cosmesis. Since the breast is highly deformable, it is difficult for the surgeon to keep track of the tumour location, orientation and shape during surgery based on preoperative mammogram/ultrasound images. When a breast tumour is palpable, i.e., it can be felt by the surgeon's hand, performing lumpectomy is relatively straightforward. When the tumour is impalpable, however, the surgeon must perform the surgery by relying on a guidewire implanted preoperatively into the breast for marking the tumour location. This imprecise way fails to clearly identify an impalpable tumour for the surgeon and causes repeat surgeries that reduce the cosmetic benefits of lumpectomy and may delay supplemental treatments for breast cancer. These challenges can be mitigated with better localization and visualization of tumours. We propose a robotics and augmented reality-based surgeon-assist solution to the issues of planning and executing breast lumpectomy using algorithms for ultrasound image-based tumour finding and tracking and augmented-reality tumour visualization. The augmented-reality display will visually guide the surgeon to the tumour location in an unobtrusive and intuitive manner by overlaying an image of the tumour on the patient's physical breast. This technology will enable surgeons to more accurately plan and execute lumpectomy. Our low-cost solution improves the accuracy in lesion localization/visualization, reduces the procedure length, and enhances the surgeon's situational awareness while enhancing post-lumpectomy breast cosmesis for patients.

对于早期乳腺癌，治疗方案包括乳房切除术，其中乳房被完全切除，乳房肿瘤切除术（保乳手术），其中仅切除肿瘤和部分邻近组织。肿块切除术往往是首选妇女的一些因素，包括美容。由于乳房是高度可变形的，因此外科医生难以在手术期间基于术前乳房X线照片/超声图像跟踪肿瘤位置、取向和形状。当乳房肿瘤是可触及的，即，手术医生的手可以感觉到，所以进行乳房肿瘤切除术相对简单。然而，当肿瘤无法触及时，外科医生必须依靠术前植入乳房的导丝来标记肿瘤位置来进行手术。这种不精确的方法无法为外科医生清楚地识别出一个无法触及的肿瘤，并导致重复手术，降低了乳房肿瘤切除术的美容效果，并可能延迟乳腺癌的补充治疗。 这些挑战可以通过更好的肿瘤定位和可视化来缓解。我们提出了一个基于机器人和增强现实的外科医生辅助解决方案，规划和执行乳房肿块切除术的问题，使用基于超声图像的肿瘤发现和跟踪算法和增强现实肿瘤可视化。增强现实显示器将通过将肿瘤图像叠加在患者的物理乳房上，以不显眼和直观的方式在视觉上引导外科医生到达肿瘤位置。这项技术将使外科医生能够更准确地计划和执行乳房肿瘤切除术。我们的低成本解决方案提高了病变定位/可视化的准确性，缩短了手术时间，增强了外科医生的情景意识，同时增强了患者乳房肿瘤切除术后的乳房美容效果。