Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy.
Department of Information Engineering (DII), Universitá Politecnica delle Marche, via Brecce Bianche, 12, 60131, Ancona, AN, Italy.
Ann Biomed Eng. 2020 Aug;48(8):2171-2191. doi: 10.1007/s10439-020-02553-6. Epub 2020 Jun 29.
With the advent of Minimally Invasive Surgery (MIS), intra-operative imaging has become crucial for surgery and therapy guidance, allowing to partially compensate for the lack of information typical of MIS. This paper reviews the advancements in both classical (i.e. ultrasounds, X-ray, optical coherence tomography and magnetic resonance imaging) and more recent (i.e. multispectral, photoacoustic and Raman imaging) intra-operative imaging modalities. Each imaging modality was analyzed, focusing on benefits and disadvantages in terms of compatibility with the operating room, costs, acquisition time and image characteristics. Tables are included to summarize this information. New generation of hybrid surgical room and algorithms for real time/in room image processing were also investigated. Each imaging modality has its own (site- and procedure-specific) peculiarities in terms of spatial and temporal resolution, field of view and contrasted tissues. Besides the benefits that each technique offers for guidance, considerations about operators and patient risk, costs, and extra time required for surgical procedures have to be considered. The current trend is to equip surgical rooms with multimodal imaging systems, so as to integrate multiple information for real-time data extraction and computer-assisted processing. The future of surgery is to enhance surgeons eye to minimize intra- and after-surgery adverse events and provide surgeons with all possible support to objectify and optimize the care-delivery process.
随着微创外科 (MIS) 的出现，术中成像对于手术和治疗指导变得至关重要，它可以部分弥补 MIS 中典型的信息缺乏问题。本文回顾了经典 (如超声、X 射线、光学相干断层扫描和磁共振成像) 和最近的 (如多光谱、光声和拉曼成像) 术中成像方式的进展。每种成像方式都进行了分析，重点关注其在与手术室的兼容性、成本、采集时间和图像特征方面的优缺点。文中还包括了用于总结这些信息的表格。还研究了新一代混合手术室和实时/室内图像处理算法。在空间和时间分辨率、视野和对比度组织方面，每种成像方式都有其特定的（特定部位和特定手术程序）特点。除了每种技术在指导方面的优势外，还必须考虑操作人员和患者风险、成本以及手术过程所需的额外时间。目前的趋势是为手术室配备多模态成像系统，以便实时提取和计算机辅助处理多种信息。手术的未来是增强外科医生的视野，以最大限度地减少手术中和手术后的不良事件，并为外科医生提供所有可能的支持，使护理过程客观化和最优化。
