开腹肝手术中的器官表面变形测量与分析:12 例临床病例的方法与初步结果。
Organ surface deformation measurement and analysis in open hepatic surgery: method and preliminary results from 12 clinical cases.
出版信息
IEEE Trans Biomed Eng. 2011 Aug;58(8). doi: 10.1109/TBME.2011.2146782. Epub 2011 Apr 25.
The incidence of soft tissue deformation has been well documented in neurosurgical procedures and is known to compromise the spatial accuracy of image-guided surgery systems.Within the context of image-guided liver surgery (IGLS), no detailed method to study and analyze the observed organ shape change between preoperative imaging and the intra-operative presentation has been developed. Contrary to the studies of deformation in neurosurgical procedures, the majority of deformation in IGLS is imposed prior to resection and due to laparotomy and mobilization. As such, methods of analyzing the organ shape change must be developed to use the intra-operative data (e.g. laser range scan (LRS) surfaces) acquired with the organ in its fully deformed shape. To achieve this end we use a signed closest point distance deformation metric computed after rigid alignment of the intra-operative LRS data with organ surfaces generated from the preoperative tomograms. The rigid alignment between the intra-operative LRS surfaces and pre-operative image data was computed with a feature weighted surface registration algorithm. In order to compare the deformation metrics across patients, an inter-patient non-rigid registration of the pre-operative CT images was performed. Given the inter-patient liver registrations, an analysis was performed to determine the potential similarities in the distribution of measured deformation between patients for which similar procedures had been performed. The results of the deformation measurement and analysis indicates the potential for soft tissue deformation to compromise surgical guidance information and suggests a similarity in imposed deformation among similar procedure types.
软组织变形的发生率在神经外科手术中已有充分记录,并已知会影响图像引导手术系统的空间准确性。在图像引导肝切除术(IGLS)的背景下,尚未开发出详细的方法来研究和分析术前成像与术中表现之间观察到的器官形状变化。与神经外科手术中变形的研究相反,IGLS 中的大多数变形是在切除前由于剖腹术和动员引起的。因此,必须开发分析器官形状变化的方法,以使用术中数据(例如激光距离扫描(LRS)表面)来获取完全变形的器官。为此,我们使用刚性配准后计算的有符号最近点距离变形度量,该度量用于计算术中 LRS 数据与术前断层扫描生成的器官表面之间的刚性配准。术中 LRS 表面和术前图像数据之间的刚性配准是使用特征加权曲面配准算法计算的。为了在患者之间比较变形指标,对术前 CT 图像进行了患者间非刚性配准。根据患者间的肝脏配准,进行了分析以确定在执行了相似手术的患者之间测量的变形分布的相似性。变形测量和分析的结果表明,软组织变形有可能危及手术指导信息,并表明相似手术类型之间的变形相似性。