Virtual and Augmented Reality Guidance for Hepatic RFA

描述(申请人提供)：该项目的主要目标是使用最先进的计算机可视化技术改善肝脏射频消融(RFA)治疗的临床结果。我们假设，与仅使用标准二维超声相比，医生使用上下文校正的三维(3D)可视化系统将更准确地针对肝脏肿瘤进行RFA治疗。如果被证明是有益的，这项技术可以用来降低RFA后肿瘤复发率(目前为33-48%)，并改善每年数千名肝肿瘤患者的生活。这项研究将经历四个主要研究阶段：验证我们的定量RFA模体和分割方法；使用我们的RFA模体比较几种RFA指导方法的大型随机对照试验；使用土拨鼠肝细胞癌模型的随机对照试验；以及在人体上进行安全性和有效性的小型随机对照试验。此外，我们将进行几项技术和协同研究工作，包括改进临床显示系统的校准，为此类系统开发全自动、连续的校准方法，以及确定增强的指导系统向新手医生传授RFA技术的效果。这项研究最直接的潜在好处可能是减少RFA部位附近的肿瘤复发，因为更准确地定位和估计消融区边界。这项研究还将作为开发更复杂的引导系统的基础，以便能够治疗更大和更复杂的病变。由于这项置入任务与许多其他临床消融或活检任务相似，我们预计这些结果将远远超出肝脏RFA的适用范围。最后，我们可能会发现，该系统对于训练新手用户进行空间复杂的过程(如RFA)是有效的。这项研究还将提供目前RFA所缺乏的两(2)个重要的治疗研究工具：定量准确的体模和体内肝脏肿瘤的大型动物模型。定量模型将允许小组评估准确的RFA放置和消融区预测和测量的新技术。土拨鼠模型将允许在人体研究之前进行更现实的体内实验。

DESCRIPTION (provided by applicant): The primary goal of this project is to improve the clinical outcomes of hepatic radiofrequency ablation (RFA) therapy using state-of-the-art computer visualization techniques. We hypothesize that physicians will be more accurate in targeting RFA therapy to hepatic tumors using a contextually-correct three-dimensional (3D) visualization system than they could be with standard two-dimensional ultrasound alone. If proven beneficial, this technique could be used to decrease the post-RFA tumor recurrence rate (currently 33-48%) and improve the lives of thousands of patients with hepatic tumors annually. This study will proceed through four major phases of research: validation of our quantitative RFA phantom and segmentation methods; a large, randomized controlled trial comparing several methods of RFA guidance using our RFA phantoms; a randomized, controlled trial using the woodchuck model of hepatocellular carcinoma; and, a small randomized, controlled trial of safety and efficacy in humans. In addition, we will conduct several technical and synergistic research efforts, including improving the calibration of clinical display systems, developing fully automatic, continuous calibration methods for such systems, and determining the efficacy of enhanced guidance systems for teaching RFA techniques to novice physicians. The most immediate potential benefit of this research could be reduced tumor recurrence near RFA sites because of more accurate placement and estimation of the ablation zone boundaries. This research will also serve as the groundwork for the development of more sophisticated guidance systems to enable treatment of large and more complex lesions. Because of the similarity of this placement task to many other clinical ablation or biopsy tasks, we expect that these results would have applicability well beyond hepatic RFA. Finally, we may find that this system is effective for training novice users in the conduct of spatially complex procedures like RFA. This study will also provide two (2) important therapeutic research tools that are currently lacking for RFA: a quantitative accuracy phantom and a large animal model for in vivo hepatic tumors. The quantitative phantom will allow groups to evaluate new techniques for accurate RFA placement and ablation zone prediction and measurement. The woodchuck model will allow for more realistic in vivo experimentation as a step before human studies.