A 3d-elastography-guided system for laparoscopic partial nephrectomies

Philipp J. Stolka, Matthias Keil, Georgios Sakas, Eliott McVeigh, Mohamad E. Allaf, Russell H. Taylor, Emad M. Boctor

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

We present an image-guided intervention system based on tracked 3D elasticity imaging (EI) to provide a novel interventional modality for registration with pre-operative CT. The system can be integrated in both laparoscopic and robotic partial nephrectomies scenarios, where this new use of EI makes exact intra-operative execution of pre-operative planning possible. Quick acquisition and registration of 3D-B-Mode and 3D-EI volume data allows intra-operative registration with CT and thus with pre-defined target and critical regions (e.g. tumors and vasculature). Their real-time location information is then overlaid onto a tracked endoscopic video stream to help the surgeon avoid vessel damage and still completely resect tumors including safety boundaries. The presented system promises to increase the success rate for partial nephrectomies and potentially for a wide range of other laparoscopic and robotic soft tissue interventions. This is enabled by the three components of robust real-time elastography, fast 3D-EI/CT registration, and intra-operative tracking. With high quality, robust strain imaging (through a combination of parallelized 2D-EI, optimal frame pair selection, and optimized palpation motions), kidney tumors that were previously unregistrable or sometimes even considered isoechoic with conventional B-mode ultrasound can now be imaged reliably in interventional settings. Furthermore, this allows the transformation of planning CT data of kidney ROIs to the intra-operative setting with a markerless mutual-information-based registration, using EM sensors for intraoperative motion tracking. Overall, we present a complete procedure and its development, including new phantom models - both ex vivo and synthetic - to validate image-guided technology and training, tracked elasticity imaging, real-time EI frame selection, registration of CT with EI, and finally a real-time, distributed software architecture. Together, the system allows the surgeon to concentrate on intervention completion with less time pressure.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2010
Subtitle of host publicationVisualization, Image-Guided Procedures, and Modeling
EditorsKenneth H. Wong, Michael I. Miga
PublisherSPIE
ISBN (Electronic)9780819480262
DOIs
StatePublished - Jan 1 2010
EventMedical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling - San Diego, United States
Duration: Feb 14 2010Feb 16 2010

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume7625
ISSN (Print)1605-7422

Conference

ConferenceMedical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling
CountryUnited States
CitySan Diego
Period2/14/102/16/10

Keywords

  • Distributed software
  • Elastography
  • Navigation
  • Partial nephrectomy
  • Registration
  • Ultrasound

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Stolka, P. J., Keil, M., Sakas, G., McVeigh, E., Allaf, M. E., Taylor, R. H., & Boctor, E. M. (2010). A 3d-elastography-guided system for laparoscopic partial nephrectomies. In K. H. Wong, & M. I. Miga (Eds.), Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling [76251I] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 7625). SPIE. https://doi.org/10.1117/12.844589