Improved Targeting in Minimally Invasive Image-Guided Radio Frequency Ablation

描述（由申请人提供）：这是一项为期两年的R03资助申请，用于应用新型先进图像分析技术和引入技术，以改善CT引导射频消融期间Radiobox（RF）电极的放置。该应用程序符合R03的要求，因为它是一个小型研究项目，可以在有限的资源下在短时间内进行，因为只分析回顾性数据。从本研究中获得的知识将确定将术前高分辨率图像与术中图像配准的可行性。术前采集的数据能够准确识别肿瘤边缘，并勾画出需要保留的关键组织。然而，目前，术前和术中数据的对齐是由介入肿瘤学家在心理上完成的。临床研究表明，小于3 cm的肿瘤通常采用射频消融完全治疗。然而，考虑到治疗的肿瘤尺寸较小，腹部解剖结构的非刚性运动可能会导致难以准确评估射频电极放置。目前，在射频消融期间，没有融合术前和术中数据的方法。在本初步研究中，将对BWH的可用数据进行回顾性分析。术前和术中图像将进行刚性和非刚性配准。我们将评估术前图像是否可以与术中图像配准，并更好地描述靶向时间。由于术后图像不包含可见的肿瘤，因此肿瘤是否得到完全治疗，评估通常难以确定。我们的目标还包括通过对术前和术后图像进行配准来改善对治疗结果的定量评估。成功与否将取决于所获得配准结果的准确性和稳健性。在评估结果时，将采用数学方法和放射科医生对结果的目视检查。该提案将通过开发和评估关键技术，使图像引导射频消融期间的导航增强，从而有益于公共卫生。在整个手术过程中可视化肿瘤和肿瘤边缘的能力将使介入放射科医生能够更好地实现整个肿瘤块的准确射频电极放置和凝固坏死，而不会出现意外的部位效应。

DESCRIPTION (provided by applicant): This is an R03 grant application for two years of funding to apply novel advanced image analysis techniques and introducing technology that would improve the placement of the Radiofrequency (RF) electrode during CT-guided guided RF ablation. This application qualifies as an R03 because it is a small research project that can be carried out in a short time with limited resources, as only retrospective data will be analyzed. The knowledge obtained from this study will establish the feasibility of registering pre-procedural high resolution images with intra-procedural images. Pre-procedural acquired data enables accurate identification of tumor margin and delineates critical tissue to preserve. However, currently, the alignment of pre- and intra-procedural data is done mentally by interventional oncologists. Clinical studies have shown that tumors smaller than 3 cm are often treated completely with RF ablation. Nevertheless, non-rigid motion of the abdominal anatomical structures can create difficulties in accurately assessing the RF electrode placement, considering the small size of treated tumors. Currently there is no method for fusing pre and intra-procedural data during RF ablations. A retrospective analysis of data available at BWH will be performed in this pilot study. Pre- and intra- procedural images will be both rigid and non-rigid registered. We will evaluate if pre-procedural images can be registered to intra-procedural images and delineate better the time for targeting. Since post-procedural images do not contain visible tumor, whether the tumor was completely treated, the assessment is often difficult to determine. We aim also improving the quantitative assessment of the treatment outcome by registration of pre-and post-procedural images. The success will be determined by the accuracy and robustness of the registration results obtained. Both mathematical methods and visual inspection by radiologists of results will be employed in assessing the results. This proposal will benefit public health by developing and assessing key technologies to enable enhanced navigation during the image guided radiofrequency ablation. The capacity to visualize the tumor and tumor margin throughout the procedure will better enable the interventional radiologists to achieve accurate RF electrode placement and coagulation necrosis for the entire tumor mass, without unexpected site effects.