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首页> 外文期刊>Surgical Endoscopy >Ultrasound-based tumor movement compensation during navigated laparoscopic liver interventions
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Ultrasound-based tumor movement compensation during navigated laparoscopic liver interventions

机译：腹腔镜肝脏导航术中基于超声的肿瘤运动补偿

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Background: Image-guided navigation aims to provide better orientation and accuracy in laparoscopic interventions. However, the ability of the navigation system to reflect anatomical changes and maintain high accuracy during the procedure is crucial. This is particularly challenging in soft organs such as the liver, where surgical manipulation causes significant tumor movements. We propose a fast approach to obtain an accurate estimation of the tumor position throughout the procedure. Methods: Initially, a three-dimensional (3D) ultrasound image is reconstructed and the tumor is segmented. During surgery, the position of the tumor is updated based on newly acquired tracked ultrasound images. The initial segmentation of the tumor is used to automatically detect the tumor and update its position in the navigation system. Two experiments were conducted. First, a controlled phantom motion using a robot was performed to validate the tracking accuracy. Second, a needle navigation scenario based on pseudotumors injected into ex vivo porcine liver was studied. Result: In the robot-based evaluation, the approach estimated the target location with an accuracy of 0.4 ± 0.3 mm. The mean navigation error in the needle experiment was 1.2 ± 0.6 mm, and the algorithm compensated for tumor shifts up to 38 mm in an average time of 1 s. Conclusion: We demonstrated a navigation approach based on tracked laparoscopic ultrasound (LUS), and focused on the neighborhood of the tumor. Our experimental results indicate that this approach can be used to quickly and accurately compensate for tumor movements caused by surgical manipulation during laparoscopic interventions. The proposed approach has the advantage of being based on the routinely used LUS; however, it upgrades its functionality to estimate the tumor position in 3D. Hence, the approach is repeatable throughout surgery, and enables high navigation accuracy to be maintained.
机译：背景：图像引导导航旨在在腹腔镜手术中提供更好的方向和准确性。然而，导航系统在手术过程中反映解剖学变化并保持高精度的能力至关重要。这在诸如肝脏之类的软器官中尤其具有挑战性，在这些器官中，外科手术会引起明显的肿瘤运动。我们提出了一种快速的方法来获得整个手术过程中肿瘤位置的准确估计。方法：最初，重建三维（3D）超声图像并对肿瘤进行分割。在外科手术期间，基于新近获取的跟踪的超声图像来更新肿瘤的位置。肿瘤的初始分割用于自动检测肿瘤并更新其在导航系统中的位置。进行了两个实验。首先，使用机器人执行受控的幻像运动以验证跟踪精度。其次，研究了基于注射到离体猪肝脏中的假肿瘤的针头导航方案。结果：在基于机器人的评估中，该方法以0.4±0.3 mm的精度估算了目标位置。针头实验中的平均导航误差为1.2±0.6 mm，该算法可在平均1 s的时间内补偿最大38 mm的肿瘤移位。结论：我们展示了一种基于跟踪腹腔镜超声（LUS）的导航方法，并专注于肿瘤的周围区域。我们的实验结果表明，该方法可用于快速，准确地补偿腹腔镜干预期间由外科手术引起的肿瘤运动。所提出的方法具有基于常规使用的LUS的优点。但是，它会升级其功能以估计3D中的肿瘤位置。因此，该方法在整个手术中都是可重复的，并且能够保持较高的导航精度。

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