Improved Targeting in Minimally Invasive Image-Guided Radio Frequency Ablation R03-EB006515
This collaboration aims to apply novel advanced image analysis techniques and to introduce technology that would improve the placement of a radiofrequency (RF) electrode during CT-guided guided RF ablation. The knowledge obtained from this study will establish the feasibility of registering pre-procedural high resolution images with intra-procedural images. Pre-procedural acquired data enables accurate identification of tumor margin and delineates critical tissue to preserve. However, currently, the alignment of pre- and intra-procedural data is done mentally by interventional oncologists. Clinical studies have shown that tumors smaller than 3 cm are often treated completely with RF ablation. Nevertheless, non-rigid motion of the abdominal anatomical structures can create difficulties in accurately assessing the RF electrode placement, considering the small size of treated tumors.
Currently, there is no method for fusing pre- and intra-procedural data during RF ablations. A retrospective analysis of data available at BWH will be performed in this pilot study. Pre- and intra-procedural images will be both rigidly and non-rigidly registered. We will evaluate if pre-procedural images can be registered to intra-procedural images and better delineate the time for targeting. Since post-procedural images do not contain visible tumor, whether the tumor was completely treated, the assessment is often difficult to determine. We aim also to improve the quantitative assessment of the treatment outcome by registering pre- and post-procedural images.
Success will be determined by the accuracy and robustness of the obtained registration results. Both mathematical methods and visual inspection of results by radiologists will be employed in assessing the results. This proposal will benefit public health by developing and assessing key technologies to enable enhanced navigation during the image- guided RF ablation. The capacity to visualize the tumor and tumor margin throughout the procedure will better enable the interventional radiologists to achieve accurate RF electrode placement and coagulation necrosis for the entire tumor mass without unexpected side effects.
Publications
- Wang M, Rohling R, Duzenli C, Clark B, Archip N. Evaluation of targeting errors in ultrasound-assisted radiotherapy. Ultrasound Med Biol. 2008 Dec;34(12):1944-56. PMID: 18723271.
- Archip N, Clatz O, Whalen S, Dimaio S, Black P, Jolesz F, Golby A, Warfield S. Compensation of geometric distortion effects on intraoperative magnetic resonance imaging for enhanced visualization in image-guided neurosurgery. Neurosurgery. 2008 Mar;62(3 Suppl 1):209-15; discussion 215-6. PMID: 18424988.
- Archip N, Clatz O, Whalen S, Kacher D, Fedorov A, Kot A, Chrisochoides N, Jolesz F, Golby A, Black P, Warfield S. Non-rigid alignment of pre-operative MRI, fMRI, and DT-MRI with intra-operative MRI for enhanced visualization and navigation in image-guided neurosurgery. Neuroimage. 2007 Apr 1;35(2):609-624. PMID: 17289403.
- Archip N, Jolesz F, Warfield S. A validation framework for brain tumor segmentation. Acad Radiol. 2007 Oct;14(10):1242-51. PMID: 17889341.
- Archip N, Tatli S, Morrison P, Jolesz F, Warfield S, Silverman S. Non-rigid registration of pre-procedural MR images with intra- procedural unenhanced CT images for improved targeting of tumors during liver radiofrequency ablations. Int Conf Med Image Comput Comput Assist Interv. 2007;10(Pt 2):969-77. PMID: 18044662.