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拨款申请，用于应用新颖的先进图像分析技术，并引入技术，以改善ct引导引导射频消融期间射频（RF）电极的放置。这个申请是R03，因为它是一个小的研究项目，可以在有限的资源下在短时间内进行，因为只有回顾性的数据将被分析。从本研究中获得的知识将建立程序前高分辨率图像与程序内图像配准的可行性。手术前获得的数据能够准确地识别肿瘤边缘，并描绘出需要保存的关键组织。然而，目前，手术前和手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3cm的肿瘤通常可以用射频消融术完全治疗。然而，考虑到治疗肿瘤的小尺寸，腹部解剖结构的非刚性运动可能会给准确评估射频电极的放置带来困难。目前还没有一种方法可以融合射频消融过程中的术前和术中数据。在这项试点研究中，将对BWH现有数据进行回顾性分析。程序前和程序内图像将同时进行刚性和非刚性配准。我们将评估手术前图像是否可以与手术内图像匹配，并更好地描述瞄准时间。由于术后图像不包含可见肿瘤，因此肿瘤是否得到完全治疗，往往难以评估。我们的目标是通过注册手术前和手术后的图像来改善治疗结果的定量评估。成功与否将取决于所获得的配准结果的准确性和鲁棒性。评估结果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来增强图像引导射频消融期间的导航，从而有益于公众健康。在整个手术过程中，肿瘤和肿瘤边缘的可视化能力将更好地使介入放射科医生能够实现准确的射频电极放置和整个肿瘤块的凝固坏死，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.