Toward realistic radiofrequency ablation of hepatic tumors 3D simulation and planning

Villard, Caroline; Soler, Luc; Gangi, Afshin; Mutter, Didier; Marescaux, Jacques

doi:doi:10.1117/12.534871

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Toward realistic radiofrequency ablation of hepatic tumors 3D simulation and planning

Proc. SPIE 5367, 586 (2004); http://dx.doi.org/10.1117/12.534871

Sunday 15 February 2004

San Diego, CA, USA

Medical Imaging 2004: Visualization, Image-Guided Procedures, and Display

Robert L. Galloway, Jr.

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Abstract

Caroline Villard

LSIIT/CNRS-Univ. Louis Pasteur Strasbourg I (France)

Luc Soler, Didier Mutter, and Jacques Marescaux

IRCAD-EITS (France)

Afshin Gangi

Hopital Civil de Strasbourg (France)

Radiofrequency ablation (RFA) has become an increasingly used technique in the treatment of patients with unresectable hepatic tumors. Evaluation of vascular architecture, post-RFA tissue necrosis prediction, and the choice of a suitable needle placement strategy using conventional radiological techniques remain difficult. In an attempt to enhance the safety of RFA, a 3D simulator and treatment planning tool, that simulates the necrosis of the treated area, and proposes an optimal placement for the needle, has been developed. From enhanced spiral CT scans with 2 mm cuts, 3D reconstructions of patients with liver metastases are automatically generated. Virtual needles can be added to the 3D scene, together with their corresponding zones of necrosis that are displayed as a meshed spheroids representing the 60° C isosurface. The simulator takes into account the cooling effect of local vessels greater than 3mm in diameter, making necrosis shapes more realistic. Using a voxel-based algorithm, RFA spheroids are deformed following the shape of the vessels, extended by an additional cooled area. This operation is performed in real-time, allowing updates while needle is adjusted. This allows to observe whether the considered needle placement strategy would burn the whole cancerous zone or not. Planned needle positioning can also be automatically generated by the software to produce complete destruction of the tumor with a 1 cm margin, with maximum respect of the healthy liver and of all major extrahepatic and intrahepatic structures to avoid. If he wishes, the radiologist can select on the skin an insertion window for the needle, focusing the research of the trajectory.

Digital Object Identifier

http://dx.doi.org/10.1117/12.534871

Citation

Caroline Villard, Luc Soler, Afshin Gangi, Didier Mutter and Jacques Marescaux, "Toward realistic radiofrequency ablation of hepatic tumors 3D simulation and planning", Proc. SPIE 5367, 586 (2004); http://dx.doi.org/10.1117/12.534871