Abstract
Most patients with liver tumors are not candidates for surgical resection. A number of local treatment methods for unresectable liver tumors have recently received considerable interests. The major task of these procedures is accurate needle placement with the aim of complete tumor removal and minimal damage to surrounding normal liver parenchyma. In this article, we review the current status of interventional navigation system (INS) for treatment of unresectable liver tumors in terms of overall workflow, tracking systems, and research development. The conceptual design of INS consists of pre-operative and intra-operative modules. The tracking system falls into three types: optical, electromagnetic, and MR gradient based. The current INS, according to their image modalities, can be classified into four categories: MRI based, CT based, U/S based, and multimodalities based. The article also discusses the future research direction for enhanced performance of INS with real time imaging, high accuracy, high resolution, and friendly user-interface.
Similar content being viewed by others
References
Abe H, Kurumi Y, Naka S, Shiomi H, Umeda T, Naitoh H, Endo Y, Hanasawa K, Morikawa S, Tani T (2005) Open-configuration MR-guided microwave thermocoagulation therapy for metastatic liver tumors from breast cancer. Breast Cancer 12(1):26–31
Banovac F, Tang J, Xu S, Lindisch D, Chung HY, Levy EB, Chang T, McCullough MF, Yaniv Z, Wood BJ, Cleary K (2005) Precision targeting of liver lesions using a novel electromagnetic navigation device in physiologic phantom and swine. Med Phys 32(8):2698–2705
Beller S, Hunerbein M, Eulenstein S, Lange T, Schlag PM (2007) Feasibility of navigated resection of liver tumors using multiplanar visualization of intraoperative 3-dimensional ultrasound data. Ann Surg 246(2):288–294
Chopra SS, Hunerbein M, Eulenstein S, Lange T, Schlag PM, Beller S (2008) Development and validation of a three dimensional ultrasound based navigation system for tumor resection. Eur J Surg Oncol 34(4):456–461
Curiel L, Chavrier F, Gignoux B, Pichardo S, Chesnais S, Chapelon JY (2004) Experimental evaluation of lesion prediction modelling in the presence of cavitation bubbles: intended for high-intensity focused ultrasound prostate treatment. Med Biol Eng Comput 42(1):44–54
Curley SA, Izzo F, Delrio P, Ellis LM, Granchi J, Vallone P, Fiore F, Pignata S, Daniele B, Cremona F (1999) Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 230(1):1–8
Dutton AQ, Yeo SJ, Yang KY, Lo NN, Chong HC (2008) Computer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty. A prospective, randomized study. J Bone Joint Surg Am 90(1):2–9
Goldberg SN (2001) Radiofrequency tumor ablation: principles and techniques. Eur J Ultrasound 13(2):129–147
Hancock CP, Chaudhry S, Wall P, Goodman AM (2007) Proof of concept percutaneous treatment system to enable fast and finely controlled ablation of biological tissue. Med Biol Eng Comput 45(6):531–540
Hildebrand P, Martens V, Schweikard A, Schlichting S, Besirevic A, Kleemann M, Roblick U, Mirow L, Burk C, Bruch HP (2007) Evaluation of an online navigation system for laparoscopic interventions in a perfused ex vivo artificial tumor model of the liver. HPB (Oxford) 9(3):190–194
Hildebrand P, Schlichting S, Martens V, Besirevic A, Kleemann M, Roblick U, Mirow L, Burk C, Schweikard A, Bruch HP (2008) Prototype of an intraoperative navigation and documentation system for laparoscopic radiofrequency ablation: first experiences. Eur J Surg Oncol 34(4):418–421
Hong J, Nakashima H, Konishi K, Ieiri S, Tanoue K, Nakamuta M, Hashizume M (2006) Interventional navigation for abdominal therapy based on simultaneous use of MRI and ultrasound. Med Biol Eng Comput 44(12):1127–1134
Kleemann M, Hildebrand P, Birth M, Bruch HP (2006) Laparoscopic ultrasound navigation in liver surgery: technical aspects and accuracy. Surg Endosc 20(5):726–729
Kurumi Y, Tani T, Naka S, Shiomi H, Shimizu T, Abe H, Endo Y, Morikawa S (2007) MR-guided microwave ablation for malignancies. Int J Clin Oncol 12(2):85–93
Leyendecker JR, Dodd GD (2001) 3rd minimally invasive techniques for the treatment of liver tumors. Semin Liver Dis 21(2):283–291
Maier-Hein L, Pianka F, Seitel A, Muller SA, Tekbas A, Seitel M, Wolf I, Schmied BM, Meinzer HP (2007) Precision targeting of liver lesions with a needle-based soft tissue navigation system. Med Image Comput Comput Assist Interv Int Conf Med Image Comput Comput Assist Interv 10(Pt 2):42–49
Maier-Hein L, Muller SA, Pianka F, Worz S, Muller-Stich BP, Seitel A, Rohr K, Meinzer HP, Schmied BM, Wolf I (2008) Respiratory motion compensation for CT-guided interventions in the liver. Comput Aided Surg 13(3):125–138
Mogami T, Dohi M, Harada J (2002) A new image navigation system for MR-guided cryosurgery. Magn Reson Med Sci 1(4):191–197
Pearson AS, Izzo F, Fleming RY, Ellis LM, Delrio P, Roh MS, Granchi J, Curley SA (1999) Intraoperative radiofrequency ablation or cryoablation for hepatic malignancies. Am J Surg 178(6):592–599
Sato K, Morikawa S, Inubushi T, Kurumi Y, Naka S, Haque HA, Demura K, Tani T (2005) Alternate biplanar MR navigation for microwave ablation of liver tumors. Magn Reson Med Sci 4(2):89–94
Scheele J, Stang R, Altendorf-Hofmann A, Paul M (1995) Resection of colorectal liver metastases. World J Surg 19(1):59–71
Schlenzka D, Laine T, Lund T (2000) Computer-assisted spine surgery. Eur Spine J 9(Suppl 1):S57–S64
Shiina S, Teratani T, Obi S, Hamamura K, Koike Y, Omata M (2001) Percutaneous ethanol injection therapy for liver tumors. Eur J Ultrasound 13(2):95–106
Shinoura N, Tabei Y, Yamada R, Saito K, Takahashi M (2008) Continuous intrathecal treatment with methotrexate via subcutaneous port: implication for leptomeningeal dissemination of malignant tumors. J Neurooncol 87(3):309–316
Sjolie E, Langø T, Ystgaard B, Tangen GA, Nagelhus Hernes TA, Marvik R (2003) 3D ultrasound-based navigation for radiofrequency thermal ablation in the treatment of liver malignancies. Surg Endosc 17(6):933–938
Stippel DL, Bohm S, Beckurts KT, Brochhagen HG, Holscher AH (2002) Experimental evaluation of accuracy of radiofrequency ablation using conventional ultrasound or a third-dimension navigation tool. Langenbecks Arch Surg 387(7–8):303–308
Uddin FJ, Sama A, Jones NS (2003) Three-dimensional computer-aided endoscopic sinus surgery. J Laryngol Otol 117(5):333–339
Vogl TJ, Eichler K, Straub R, Engelmann K, Zangos S, Woitaschek D, Bottger M, Mack MG (2001) Laser-induced thermotherapy of malignant liver tumors: general principals, equipment(s), procedure(s)–side effects, complications and results. Eur J Ultrasound 13(2):117–127
Weinberg BD, Patel RB, Wu H, Blanco E, Barnett CC, Exner AA, Saidel GM, Gao J (2008) Model simulation and experimental validation of intratumoral chemotherapy using multiple polymer implants. Med Biol Eng Comput 46(10):1039–1049
Woodworth BA, Chiu AG, Cohen NA, Kennedy DW, O’Malley BW Jr, Palmer JN (2008) Real-time computed tomography image update for endoscopic skull base surgery. J Laryngol Otol 122(4):361–365
Zhang H, Banovac F, Lin R, Glossop N, Wood BJ, Lindisch D, Levy E, Cleary K (2006) Electromagnetic tracking for abdominal interventions in computer aided surgery. Comput Aided Surg 11(3):127–136
Acknowledgment
This study was supported in part by the National Medical Research Council (Singapore) under Grants NMRC/0827/2004 and NMRC/TCR/001/2007.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Phee, S.J., Yang, K. Interventional navigation systems for treatment of unresectable liver tumor. Med Biol Eng Comput 48, 103–111 (2010). https://doi.org/10.1007/s11517-009-0568-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11517-009-0568-3