Accuracy of deformable image registration techniques for alignment of longitudinal cholangiocarcinoma CT images

Sen, A. K.; Anderson, Brian; Cazoulat, Guillaume; McCulloch, Molly M.; Elganainy, Dalia; McDonald, Brigid A.; He, Yulun; Mohamed, Abdallah S.R.; Elgohari, Baher; Zaid, Mohamed; Koay, Eugene J.; Brock, Kristy K.

doi:10.1002/mp.14029

Cited by 20 publications

(19 citation statements)

References 31 publications

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“…This might lead to an underestimation of tumor coverage as assessed by QAM if computed on the immediate post-interventional scan. Also, even though the QAM metric was designed for use in all approaches of percutaneous ablation, it might be more difficult to apply if ablation is performed without stereotactic navigation, in which case software for deformable registration would be required ( 33 ). Since registration inaccuracies would lead to imprecise estimation of QAM, verifying registration accuracy before applying the QAM method is crucial.…”

Section: Discussionmentioning

confidence: 99%

Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors

et al. 2021

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BackgroundIn thermal ablation of liver tumors, complete coverage of the tumor volume by the ablation volume with a sufficient ablation margin is the most important factor for treatment success. Evaluation of ablation completeness is commonly performed by visual inspection in 2D and is prone to inter-reader variability. This work aimed to introduce a standardized approach for evaluation of ablation completeness after CT-guided thermal ablation of liver tumors, using volumetric quantitative ablation margins (QAM).MethodsA QAM computation metric based on volumetric segmentations of tumor and ablation areas and signed Euclidean surface distance maps was developed, including a novel algorithm to address QAM computation in subcapsular tumors. The code for QAM computation was verified in artificial examples of tumor and ablation spheres simulating varying scenarios of ablation margins. The applicability of the QAM metric was investigated in representative cases extracted from a prospective database of colorectal liver metastases (CRLM) treated with stereotactic microwave ablation (SMWA).ResultsApplicability of the proposed QAM metric was confirmed in artificial and clinical example cases. Numerical and visual options of data presentation displaying substrata of QAM distributions were proposed. For subcapsular tumors, the underestimation of tumor coverage by the ablation volume when applying an unadjusted QAM method was confirmed, supporting the benefits of using the proposed algorithm for QAM computation in these cases. The computational code for developed QAM was made publicly available, encouraging the use of a standard and objective metric in reporting ablation completeness and margins.ConclusionThe proposed volumetric approach for QAM computation including a novel algorithm to address subcapsular liver tumors enables precision and reproducibility in the assessment of ablation margins. The quantitative feedback on ablation completeness opens possibilities for intra-operative decision making and for refined analyses on predictability and consistency of local tumor control after thermal ablation of liver tumors.

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Section: Discussionmentioning

confidence: 99%

Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors

et al. 2021

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“…The spatial resolution of the CT scans ranged between 0.66 × 0.66 mm and 0.98 × 0.98 mm in the axial plane and the slice spacing ranged from 2 and 5 mm. For evaluation of the accuracy of DIR methods, five corresponding landmarks were previously manually identified in each pair of longitudinal images 10,11 …”

Section: Methodsmentioning

confidence: 99%

Detection of vessel bifurcations in CT scans for automatic objective assessment of deformable image registration accuracy

et al. 2021

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Objective assessment of deformable image registration (DIR) accuracy often relies on the identification of anatomical landmarks in image pairs, a manual process known to be extremely time-expensive. The goal of this study is to propose a method to automatically detect vessel bifurcations in images and assess their use for the computation of target registration errors (TREs). Materials and methods: Three image datasets were retrospectively analyzed. The first dataset included 10 pairs of inhale/exhale phases from lung 4DCTs and full inhale and exhale breath-hold CT scans from 10 patients presenting with chronic obstructive pulmonary disease, with 300 corresponding landmarks available for each case (DIR-Lab). The second dataset included six pairs of inhale/exhale phases from lung 4DCTs (POPI dataset), with 100 pairs of landmarks for each case. The third dataset included 28 pairs of pre/post-radiotherapy liver contrast-enhanced CT scans, each with five manually picked vessel bifurcation correspondences. For all images, the vasculature was autosegmented by computing and thresholding a vesselness image. Images of the vasculature centerline were computed, and bifurcations were detected based on centerline voxel neighbors' count. The vasculature segmentations were independently registered using a Demons algorithm between representations of their surface with distance maps. Detected bifurcations were considered as corresponding when distant by less than 5 mm after vasculature DIR. The selected pairs of bifurcations were used to calculate TRE after registration of the images considering three algorithms: rigid registration, Anaconda, and a Demons algorithm. For comparison with the ground truth, TRE values calculated using the automatically detected correspondences were interpolated in the whole organs to generate TRE maps. The performance of the method in automatically calculating TRE after image registration was quantified by measuring the correlation with the TRE obtained when using the ground truth landmarks. Results:The median Pearson correlation coefficients between ground truth TRE and corresponding values in the generated TRE maps were r = 0.81 and r = 0.67 for the lung and liver cases, respectively. The correlation coefficients between mean TRE for each case were r = 0.99 and r = 0.64 for the lung and liver cases, respectively. Conclusion: For lungs or liver CT scans DIR, a strong correlation was obtained between TRE calculated using manually picked or landmarks automatically detected with the proposed method. This tool should be particularly useful in studies requiring assessing the reliability of a high number of DIRs.

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“…Fourth, soft tissue organs such as the liver surface, intrahepatic structures and the bile duct tree are usually deformed intraoperatively due to changes in position and surgical procedures[ 20 ]. Although studies have also described calibration algorithms based on deformed organs, the currently available DIR algorithms still have limitations when dealing with complex deformations including volume changes, and optimization solutions for variable organ alignment remain a difficult area for future research, and further development and testing studies are needed in the future[ 21 ].…”

Section: Three-dimensinal Visualization Images and Their Extensionmentioning

confidence: 99%

Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery

Wang¹,

Cao²,

Chen³

et al. 2021

WJGS

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With the continuous development of digital medicine, minimally invasive precision and safety have become the primary development trends in hepatobiliary surgery. Due to the specificity and complexity of hepatobiliary surgery, traditional preoperative imaging techniques such as computed tomography and magnetic resonance imaging cannot meet the need for identification of fine anatomical regions. Imaging-based three-dimensional (3D) reconstruction, virtual simulation of surgery and 3D printing optimize the surgical plan through preoperative assessment, improving the controllability and safety of intraoperative operations, and in difficult-to-reach areas of the posterior and superior liver, assistive robots reproduce the surgeon’s natural movements with stable cameras, reducing natural vibrations. Electromagnetic navigation in abdominal surgery solves the problem of conventional surgery still relying on direct visual observation or preoperative image assessment. We summarize and compare these recent trends in digital medical solutions for the future development and refinement of digital medicine in hepatobiliary surgery.

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Accuracy of deformable image registration techniques for alignment of longitudinal cholangiocarcinoma CT images

Cited by 20 publications

References 31 publications

Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors

Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors

Detection of vessel bifurcations in CT scans for automatic objective assessment of deformable image registration accuracy

Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery

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