Concepts and preliminary data toward the realization of image-guided liver surgery. 2007

David M Cash, and Michael I Miga, and Sean C Glasgow, and Benoit M Dawant, and Logan W Clements, and Zhujiang Cao, and Robert L Galloway, and William C Chapman
Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.

Image-guided surgery provides navigational assistance to the surgeon by displaying the surgical probe position on a set of preoperative tomograms in real time. In this study, the feasibility of implementing image-guided surgery concepts into liver surgery was examined during eight hepatic resection procedures. Preoperative tomographic image data were acquired and processed. Accompanying intraoperative data on liver shape and position were obtained through optically tracked probes and laser range scanning technology. The preoperative and intraoperative representations of the liver surface were aligned using the iterative closest point surface matching algorithm. Surface registrations resulted in mean residual errors from 2 to 6 mm, with errors of target surface regions being below a stated goal of 1 cm. Issues affecting registration accuracy include liver motion due to respiration, the quality of the intraoperative surface data, and intraoperative organ deformation. Respiratory motion was quantified during the procedures as cyclical, primarily along the cranial-caudal direction. The resulting registrations were more robust and accurate when using laser range scanning to rapidly acquire thousands of points on the liver surface and when capturing unique geometric regions on the liver surface, such as the inferior edge. Finally, finite element models recovered much of the observed intraoperative deformation, further decreasing errors in the registration. Image-guided liver surgery has shown the potential to provide surgeons with important navigation aids that could increase the accuracy of targeting lesions and the number of patients eligible for surgical resection.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006498 Hepatectomy Excision of all or part of the liver. (Dorland, 28th ed) Hepatectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D025321 Surgery, Computer-Assisted Surgical procedures conducted with the aid of computers. Used in various types of surgery for implant placement and instrument guidance. Image-guided surgery interactively combines prior CT scans or MRI images with real-time video. Computer-Assisted Surgery,Image-Guided Surgery,Surgery, Image-Guided,Surgical Navigation,Computer-Aided Surgery,Computer Aided Surgery,Computer Assisted Surgery,Computer-Aided Surgeries,Computer-Assisted Surgeries,Image Guided Surgery,Image-Guided Surgeries,Navigation, Surgical,Surgeries, Computer-Aided,Surgeries, Computer-Assisted,Surgeries, Image-Guided,Surgery, Computer Assisted,Surgery, Computer-Aided,Surgery, Image Guided

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