Towards the clinical integration of an image-guided navigation system for percutaneous liver tumor ablation using freehand 2D ultrasound images

Figures & data

Figure 1. Manual improvement of the liver surface segmentation result by moving the control point (left); selection of the right wall of the cube allows movement to curve in the corresponding spatial direction (bottom left corner in the same picture); the liver vessel model represented as a set of central lines (right-up); control points for the selected curve for manual correction of the spatial position (right-down).

Figure 2. Focal liver lesion – volumetric presentation (left) and abdominal surface of the patient with markers (red) and selected entry point (yellow) (right).

Figure 3. Integrated marker photo (left); marker construction (right): part visible on CT (1), part visible to the video metric tracking system (2), and the adhesive element (3).

Figure 4. With markers attached (right) that are visible on CT images (left), with nine markers attached to the patient.[10].

Figure 5. The time course of marker relative position (mm), breathing phase (normalized value) and FRE (mm) for a selected patient.

Figure 6. Correlations between the US sequences and 4DCT images: main scores of PCA analysis for the US sequence (a) and the 4DCT sequence (e), Hilbert transform phase signal for the US sequence (b) and the 4DCT sequence (d), and 4DCT phase corresponding to each US frame (c).

Figure 7. US image (left), slice of the 4DCT data at the corresponding respiratory phase and section plane (middle) and fusion with US in a color overlay (right). Rows denote four different time steps: inhalation (Figure 6a – I), deflation (Figure 6a – II), exhalation (Figure 6a – III) and inflation (Figure 6a – IV).

Figure 8. The graphical user interface supported needle insertion (up); tissue resistance during swine RFA liver ablation from Olympus Celon device (bottom).

Table I. Anatomical position of skin markers during measurements.[9]

Anatomical location	Grounds
Xiphoid process	Point fixed to the bony structures in the midline of the body
Intersection of midclavicular line and right costal margin	Anatomical point fixed to the bony structures
Intersection of anterior axillary line and right costal margin	Anatomical point fixed to the bony structures
Intersection of midclavicular line and left costal margin	Anatomical point fixed to the bony structures
Intersection of anterior axillary line and left costal margin	Anatomical point fixed to the bony structures

Table II. Errors of attached patient markers for rigid registration for median FRE.[10]

Error type	Median value of FRE (mm)
	Min			Max			Mean
	Exhale	inhale	total	Exhale	inhale	total	Exhale	inhale	total
FRE rigid	2.27	3.09	3.07	32.8	52	51.69	9.37	16.75	15.56

Spinczyk D. Image-based guidance of percutaneous abdomen intervention based on markers semi-automatic rigid registration. Videosurgery Miniin 2014;9: 246–251.

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Spinczyk D. Assistance in destroying focal lesions in the liver using image navigation. Adv Intell Syst Comput 2014;284:15–24.

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