Radiofrequency ablation of hepatic tumors: simulation, planning, and contribution of virtual reality and haptics

Abstract

For radiofrequency ablation (RFA) of liver tumors, evaluation of vascular architecture, post-RFA necrosis prediction, and the choice of a suitable needle placement strategy using conventional radiological techniques remain difficult. In an attempt to enhance the safety of RFA, a 3D simulator, treatment planning, and training tool, that simulates the insertion of the needle, the necrosis of the treated area, and proposes an optimal needle placement, has been developed. The 3D scenes are automatically reconstructed from enhanced spiral CT scans. The simulator takes into account the cooling effect of local vessels greater than 3 mm in diameter, making necrosis shapes more realistic. Optimal needle positioning can be automatically generated by the software to produce complete destruction of the tumor, with maximum respect of the healthy liver and of all major structures to avoid. We also studied how the use of virtual reality and haptic devices are valuable to make simulation and training realistic and effective.

Keywords:

• Minimally invasive surgery
• Treatment simulation and planning
• Computer-assisted surgery
• 3D visualization
• Virtual reality
• Haptic interfaces

Acknowledgements

The authors would like to thank EPML IRMC§ (EPML 9 CNRS-STIC) for its financial support. We are also grateful to Daniel Marjoux, Olivier Kuhn, and Yann Moalic for their help on these works.

Notes

^§Equipe-Projet Multi-Laboratoires Imagerie et Robotique Médicale et Chirurgicale; http://irmc.u-strasbg.fr/.