Ultrasound-based navigation for open liver surgery using active liver tracking.

Area of Science:

• Surgical Navigation
• Medical Imaging
• Hepatobiliary Surgery

Background:

• Intraoperative localization of liver lesions after systemic treatment remains challenging despite preoperative imaging.
• An image-guided navigation system was developed to integrate preoperative data with intraoperative ultrasound (US).

Purpose of the Study:

• To assess the workflow and accuracy of a novel navigation system that compensates for liver motion.
• To enable overlay of detailed preoperative diagnostic images onto intraoperative US for enhanced visualization.

Main Methods:

• Electromagnetic (EM) tracking for organ and transducer motion compensation.
• Landmark-based registration using preoperative 3D models and intraoperative ultrasound.
• Fixation of a liver sensor near the target lesion to account for local movement.

Main Results:

• 22 navigated procedures were successfully performed.
• Mean fiducial registration error was 10.3 ± 4.3 mm; mean target registration error was 8.5 ± 4.2 mm.
• Navigation system was available after an average of 12.7 minutes.

Conclusions:

• A novel navigation method combining ultrasound and active liver tracking was developed, achieving accuracy below 10 mm.
• The system effectively compensates for liver motion, improving surgical navigation reliability.
• This advancement offers significant potential for enhanced intraoperative guidance in liver procedures.