Real-Time Fusion of Ultrasound and Gamma Probe for Navigated Localization of Liver Metastases

Liver metastases are an advanced stage of several types of cancer, usually treated with surgery. Intra-operative localization of these lesions is currently facilitated by intra-operative ultrasound (IOUS) and palpation, yielding a high rate of false positives due to benign abnormal regions. In this paper we present the integration of functional nuclear information from a gamma probe with IOUS, to provide a synchronized, real-time visualization that facilitates the detection of active metastases intra-operatively. We evaluate the system in an ex-vivo setup employing a group of physicians and medical technicians and show that the addition of functional imaging improves the accuracy of localizing and identifying malignant and benign lesions significantly. Furthermore we are able to demonstrate that the inclusion of an advanced, augmented visualization provides more reliability and confidence on classifying these lesions in the presented evaluation setup.

[1]  Francesco Scopinaro,et al.  Somatostatin receptor scintigraphy in liver metastasis detection from gastroenteropancreatic neuroendocrine tumors. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[2]  R L Wahl,et al.  Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. , 1999, Radiographics : a review publication of the Radiological Society of North America, Inc.

[3]  Ralph A Bundschuh,et al.  Radioactive spheres without inactive wall for lesion simulation in PET. , 2008, Zeitschrift fur medizinische Physik.

[4]  R W Prager,et al.  Rapid calibration for 3-D freehand ultrasound. , 1998, Ultrasound in medicine & biology.

[5]  S. Reske,et al.  Detection of liver metastases from pancreatic cancer using FDG PET. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  Graham M. Treece,et al.  High-definition freehand 3-D ultrasound. , 2003, Ultrasound in Medicine and Biology.

[7]  L H Blumgart,et al.  Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. , 1999, Annals of surgery.

[8]  Lasse Riis Østergaard,et al.  Active Surface Approach for Extraction of the Human Cerebral Cortex from MRI , 2006, MICCAI.

[9]  P. Robinson,et al.  Imaging liver metastases: current limitations and future prospects. , 2000, The British journal of radiology.

[10]  Nassir Navab,et al.  Navigated Three Dimensional Beta Probe for Optimal Cancer Resection , 2006, MICCAI.

[11]  H. Saeger,et al.  Contrast-enhanced ultrasonography to detect liver metastases : a prospective trial to compare transcutaneous unenhanced and contrast-enhanced ultrasonography in patients undergoing laparotomy. , 2007, International journal of colorectal disease.

[12]  B. Wollenberg,et al.  High energy probe for detecting lymph node metastases with 18F-FDG in patients with head and neck cancer , 2006, Nuklearmedizin.

[13]  Oliver Kutter,et al.  CAMPAR: a software framework guaranteeing quality for medical augmented reality , 2006 .

[14]  Thomas Langø,et al.  Ultrasound Guided Surgery: Image Processing and Navigation , 2000 .