Clinical Translation of Deformation Compensation for Image-Guided Liver Surgery

图像引导肝脏手术变形补偿的临床转化

• 批准号: 8309070
• 负责人: WILLIAM Robert JARNAGIN
• 金额: $ 63.73万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8309070
• 关键词: Abdomen; Accounting; Address; Biological Preservation; Blood Vessels; Clinical; Clinical Trials; Colorectal; Colorectal Neoplasms; Communities; Complex; Computer Simulation; Data; Development; Devices; Disadvantaged; Disease; Disseminated Malignant Neoplasm; Dose; Effectiveness; Environment; Excision; Financial compensation; Frustration; General Population; Goals; Gold; Hepatic; Housing; Image; Image-Guided Surgery; Imagery; Injury to Liver; Intra-abdominal; Investigation; Laparoscopy; Lasers; Lead; Liver; Liver Failure; Liver neoplasms; Liver parenchyma; Magnetic Resonance; Mainstreaming; Malignant neoplasm of liver; Measures; Medical center; Memorial Sloan-Kettering Cancer Center; Metastatic Neoplasm to the Liver; Methodology; Methods; Modeling; Natural regeneration; Nature; Neoplasm Metastasis; Neuronavigation; New York; Operating Rooms; Operative Surgical Procedures; Organ; Outcome; Patient Care; Patients; Phase; Play; Postoperative Period; Procedures; Process; Quantitative Evaluations; Radiation; Reporting; Research; Research Personnel; Residual state; Resolution; Resources; Risk; Role; Scientist; Shapes; Site; Solutions; Staging; Supervision; Support System; Surface; Surgeon; Surgical margins; Survival Rate; System; Techniques; Technology; Testing; Therapeutic; Time; Tissue Model; Tissues; Training; Translations; Ultrasonography; Universities; Update; Work; X-Ray Computed Tomography; base; chemotherapy; clinical research site; cost; efficacy testing; experience; high standard; improved; interest; liver imaging; member; metastatic colorectal; minimally invasive; novel; patient population; research clinical testing; soft tissue; treatment strategy; tumor

DESCRIPTION (provided by applicant): To a degree, the use of soft-tissue modeling for updating image-guided navigational systems has not been embraced by the mainstream scientific community. It has only just recently found application within the neuronavigation community (although no commercial systems are available yet) and is still under investigation. Much of this frustration is not due to the growing number of methodologies but rather to a misunderstanding of the goals of model-updating, and an inability to test and validate. With respect to the former, it is naove to believe that modeling can account for all fine-scale deformations. However, the question to be answered is, within the confines of surgical margin, can model-updating significantly impact surgical resection? This is a central research hypothesis to be investigated within this application. What sets this application apart is that if the milestones are achieved, the outcome could result in a soft-tissue deformation correction system for image- guided liver surgery systems that could be immediately commercially available for patient care. More specifically, at the conclusion of this work, an image-guided liver surgical system capable of deformation correction will be generated, a preliminary experience with the fidelity of those corrections will be established, and the technology will be commercially available. This is possible because this application will leverage an ongoing relationship with Pathfinder Therapeutics Incorporated (PTI) that is in the process of testing their image-guided liver surgery (IGLS) system and an independent clinical evaluator at Memorial Sloan Kettering Cancer Center. PTI has agreed to share their technological platform with the PD as well as provide open systems and support to support the integration of the novel tissue deformation correction strategy proposed herein. Members of the PTI team have already contributed to the methodologies within this application and have vested scientific interest to continue within the scope of this application with the PD. The hypothesis that models can be used to correct for deformation within IGLS will be supported by three specific aims which involve: (1) incorporate the non-rigid correction compute node controller into the Pathfinder Therapeutics Inc. guidance platform, test, and then deploy to our clinical site, (2) evaluate intraoperative deformation correction using the compute node controller in a clinical trial, and (3) begin to investigate the controller/system within the context of minimally invasive procedures. Previous work involved the development of our registration methods and deformation correction compute node controller. We have succeeded in this endeavor and have shown promise. We are poised to complete the next phase with the deployment into a commercially available IGLS system, and the testing at an independent clinical site in two 25 patient studies as well as address minimally invasive procedures. In addition, it should be noted that while the controller will be integrated into a specific platform, the technology itself is amenable to integration with any image-guided surgery platform.

描述（由申请人提供）：在某种程度上，主流科学界没有使用软组织建模来更新图像引导的导航系统。它直到最近才在神经驱动社区中找到应用（尽管尚无商业系统可用），并且仍在调查中。这种挫败感的大部分不是由于方法的数量越来越多，而是由于对模型升级的目标的误解以及无法测试和验证。关于前者，相信建模可以解释所有细尺度变形。但是，要回答的问题是，在手术边缘的范围内，建模可以显着影响手术切除？这是一个中心研究假设，可以在此应用中进行研究。设定该应用程序的目的是，如果达到里程碑，结果可能会导致图像引导的肝脏手术系统的软组织变形校正系统，该系统可以立即用于患者护理。更具体地说，在这项工作的结论中，将产生一种能够变形校正的图像引导的肝外科手术系统，将建立以这些更正的忠诚度的初步经验，并且该技术将在商业上可用。这是可能的，因为该应用将利用与探路者疗法（PTI）的持续关系，该疗法正在测试其图像引导的肝脏手术（IGLS）系统和纪念Sloan Kettering Cancer Center Centre的独立临床评估者。 PTI已同意与PD共享其技术平台，并提供开放的系统和支持，以支持本文提出的新型组织变形校正策略的整合。 PTI团队的成员已经为本应用程序中的方法做出了贡献，并赋予了科学兴趣，以继续使用PD范围。可以使用模型来校正IGL中变形的假说将由三个涉及的特定目的支持：（1）将非rigid校正计算机控制器纳入探路者治疗Inc.指导平台，测试，然后将其部署到我们的临床临床试验中，（2）评估COMPERATION NODE CRIDERTION CORTROTION CORTION CORTROTION CORTION CORTROTION CORTION CORTARITY NODE CORTARITY NODE CORTAIRE（2）在微创过程的上下文中控制器/系统。先前的工作涉及开发我们的注册方法和变形校正计算节点控制器。我们在这项工作中取得了成功，并表现出了希望。我们准备将部署到市售的IGLS系统中完成下一阶段，并在两项25个患者研究中进行独立临床部位的测试，并解决微创手术。此外，应该指出的是，尽管控制器将集成到特定平台中，但该技术本身可以与任何图像引导的手术平台集成。