Design and implementation of an integrated navigation system basedon intraoperative nuclear probes for open and minimally invasive surgey

Klinikum rechts der Isar核医学系和Technische Universität m<e:1>信息学学院计算机辅助医疗程序主席之间的联合研究项目的目的是研究，设计和实施新的综合导航程序，使手术室的手持功能成像能够进行前哨淋巴结检测，恶性肿瘤定位和完整但最小的肿瘤切除。手持式核探针的一维信号将与6D位置和方向定位系统相结合，以创建能够在3D中重建放射性分布表面或提供功能体积信息的功能成像探针。因此，三种不同的探针测量β，低和高能量伽马活动被使用。β探针测量肿瘤示踪剂在非常接近表面的活性，从而允许控制切除边界。伽马探针测量源自组织深处的伽马辐射，可以定位癌症示踪剂（高能探针）以及前哨淋巴结的示踪剂（低能探针）。所有可用信息的组合，例如术前获得和注册的SPECT/CT和PET/CT数据，生物特征数据等，将以复杂的方式进一步纳入集成导航解决方案，用于手术过程中肿瘤和前哨淋巴结的定位和切除。集成过程、用户界面和可视化将设计用于开放和微创手术，如内窥镜和腹腔镜干预。

The aim of this joint research program between the Nuclear Medicine Department of the Klinikum rechts der Isar and the Chair for Computer Aided Medical Procedures at the Informatics faculty of the Technische Universität München is to investigate, design, and implement new integrated navigated procedures enabling handheld functional imaging in the operation room e.g. for sentinel lymph node detection, malignant tumor localization, and complete but minimal resection of tumors. The one dimensional signal of handheld nuclear probes will be combined with a 6D position and orientation localization system in order to create functional imaging probes that are capable to reconstruct a surface of a radioactivity distribution in 3D or provide functional volume information. Therefore, three different probes measuring beta, low and high energy gamma activity are used. Beta probes measure activity of tumor tracers in a very close vicinity to the surface allowing thus the control of resection border. Gamma probes measure gamma radiation that originates deep inside tissue allowing localization of cancer tracers (high energy probes) as well as tracers for sentinel lymph nodes (low energy probes). The combination of all available information e.g. preoperative acquired and registered SPECT/CT and PET/CT data, biometric data, etc. will be incorporated further in a sophisticated way in an integrated navigation solution for localization and resection of tumor and sentinel lymph nodes during surgery. The integrated process, user interface, and visualization will be designed for open and minimal invasive procedure, such as endoscopic and laparoscopic interventions.