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Feasibility of Intraoperative Navigation for Liver Resection Using Real-time Virtual Sonography With Novel Automatic

Takeshi Takamoto1, Yoshihiro Mise2, Shouichi Satou3

  • 1Divisions of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan. takamoto@nifty.com.

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Summary

A new automatic registration system for intraoperative ultrasonography (IOUS) and computed tomography (CT) images significantly speeds up the process. This innovation makes IOUS more practical for liver resections, improving usability in the operating room.

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Area of Science:

  • Medical Imaging
  • Surgical Technology
  • Hepatobiliary Surgery

Background:

  • Intraoperative ultrasonography (IOUS) tracked by computed tomography (CT) images offers clinical potential but requires complex manual registration.
  • Manual registration is a technically demanding procedure, limiting the widespread adoption of IOUS.

Purpose of the Study:

  • To evaluate the feasibility and usability of a novel automatic registration system for IOUS and CT image registration.
  • To assess the time and accuracy of this automatic registration system in liver resection patients.

Main Methods:

  • A prospective study was conducted in four high-volume liver resection centers.
  • The study involved patients undergoing laparotomy, measuring registration time and positional error of hepatic venous tributaries (V8-MHV, V5-MHV).
  • Real-time virtual sonography (RVS) with an automatic registration system was utilized.

Main Results:

  • The automatic registration system achieved successful registration in 83% of patients (43/52).
  • Positional errors for V8-MHV and V5-MHV were within acceptable ranges (11.4 mm and 16.2 mm, respectively).
  • The total registration process time averaged 36 seconds.

Conclusions:

  • The RVS with automatic registration provides a quick, easy, and accurate method for IOUS and CT image registration.
  • This system has the potential to increase the utilization of IOUS in clinical practice.
  • The technology demonstrates acceptable accuracy for guiding liver resections.