Ultrasound Based Planning and Navigation for Non-Anatomical Liver Resections – An Ex-Vivo Study

Paolucci, Iwan; Sandu, Raluca-Maria; Sahli, Luca; Prevost, Gian Andrea; Storni, Federico; Candinas, Daniel; Weber, Stefan; Lachenmayer, Anja (2020). Ultrasound Based Planning and Navigation for Non-Anatomical Liver Resections – An Ex-Vivo Study. IEEE Open Journal of Engineering in Medicine and Biology, 1, pp. 3-8. IEEE 10.1109/OJEMB.2019.2961094

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Goal: Non-anatomical resections of liver tumors can be very challenging as the surgeon cannot use anatomical landmarks on the liver surface or in the ultrasound image for guidance. This makes it difficult to achieve negative resection margins (R0) and still preserve as much healthy liver tissue as possible. Even though image-guided surgery systems have been introduced to overcome this challenge, they are still rarely used due to their inaccuracy, time-effort and complexity in usage and setup. Methods: We have developed a novel approach, which allows us to create an intra-operative resection plan using navigated ultrasound. First, the surface is scanned using a navigated ultrasound, followed by tumor segmentation on a midsection ultrasound image. Based on this information, the navigation system calculates an optimal resection strategy and displays it along with the tracked surgical instruments. In this study, this approach was evaluated by three experienced hepatobiliary surgeons on ex-vivo porcine models. Results: Using this technique, an R0 resection could be achieved in 22 out of 23 (95.7% R0 resection rate) cases with a median resection margin of 5.9 mm (IQR 3.5–7.7 mm). The resection margin between operators 1, 2 and 3 was 7.8 mm, 4.15 mm and 5.1 mm respectively (p = 0.054). Conclusions: This approach could represent a useful tool for intra-operative guidance in non-anatomical resection alongside conventional ultrasound guidance. However, instructions and training are essential especially if the operator has not used an image-guidance system before.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Paolucci, Iwan; Sandu, Raluca-Maria; Sahli, Luca Andrea; Prevost, Gian Andrea; Storni, Federico Lorenzo; Candinas, Daniel; Weber, Stefan and Lachenmayer, Anja

Subjects:

600 Technology
600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

ISSN:

2644-1276

Publisher:

IEEE

Language:

English

Submitter:

Iwan Paolucci

Date Deposited:

04 Mar 2020 13:16

Last Modified:

06 Mar 2020 10:25

Publisher DOI:

10.1109/OJEMB.2019.2961094

Uncontrolled Keywords:

Tumors , Liver , Navigation , Surgery , Ultrasonic imaging , Shape , Three-dimensional displays

BORIS DOI:

10.7892/boris.140799

URI:

https://boris.unibe.ch/id/eprint/140799

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