Liver Motion Due to Needle Pressure, Cardiac, and Respiratory Motion During the TIPS Procedure

Venkatraman, Vijay K.; Horn, Mark H. Van; Weeks, Susan M.; Bullitt, Elizabeth

doi:10.1007/978-3-540-30136-3_9

Cited by 11 publications

(8 citation statements)

References 9 publications

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“…The challenge is that, because of breathing, needle pressure and heartbeat, the liver moves as the needle is guided through the target. Therefore, a real-time registration is performed by tracking an ovoid balloon catheter lodged in the hepatic vein and its movement is used to estimate the movement of the liver's vessels [11]. In the context of this project, it is critical to initialize the position and orientation of the 3-dimensional vascular model with respect to the balloon, prior to any tracking.…”

Section: Introductionmentioning

confidence: 99%

3D/2D Model-to-Image Registration Applied to TIPS Surgery

Jomier

Bullitt

Horn

et al. 2006

Lecture Notes in Computer Science

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We have developed a novel model-to-image registration technique which aligns a 3-dimensional model of vasculature with two semiorthogonal fluoroscopic projections. Our vascular registration method is used to intra-operatively initialize the alignment of a catheter and a preoperative vascular model in the context of image-guided TIPS (Transjugular, Intrahepatic, Portosystemic Shunt formation) surgery. Registration optimization is driven by the intensity information from the projection pairs at sample points along the centerlines of the model. Our algorithm shows speed, accuracy and consistency given clinical data.

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Section: Introductionmentioning

confidence: 99%

3D/2D Model-to-Image Registration Applied to TIPS Surgery

Jomier

Bullitt

Horn

et al. 2006

Lecture Notes in Computer Science

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“…Motion is predominantly in the rostro-caudal (head to foot) direction, but movement of several millimeters occurs along the other two axes as well (Venkatraman et al, 2004). Cardiac motion contributes less to liver motion than does respiration, but cardiac motion may produce displacements of 1- 2 millimeters predominantly in the lateral direction (Venkatraman et al, 2004). …”

Section: Discussionmentioning

confidence: 99%

Vessel target location estimation during the TIPS procedure

Guillaume

Horn

Dixon

et al. 2009

Medical Image Analysis

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Creation of a Transjugular Intrahepatic Portosystemic Shunt (TIPS) requires passage of a needle toward a moving target that is only seen transiently by x-ray prior to needle passage. Intraoperative, 3D target localization would facilitate target access and improve the safety of the procedure. The clinical assumption is that patients undergoing the TIPS procedure possess rigid, cirrhotic livers that undergo only intraoperative translation without significant deformation or rotation. Based upon this assumption, we hypothesize that the position of any unseen, 3D target point within the liver can be determined intraoperatively by precalculation of the relative positions of the target point to a different 3D point that can be tracked intraoperatively. This paper examines this hypothesis using intraoperatively acquired, biplane, x-ray images of 7 patients. In 6, we tracked the effects of cardiac and respiratory motion, and in 3 the effects of needle pressure. Methods involved reconstruction of 3D vessel bifurcation and other trackable intrahepatic points from biplane angiograms, measurement of liver deformation by examining changing distances between these 3D points over time, and comparison of expected to actual displacements of these points with respect to a fixed reference point in the liver. We conclude that, for the rigid livers associated with patients undergoing TIPS, that there is less intraoperative deformation than previously reported by other groups addressing healthy liver deformation, and that the location of an unseen target can be predicted within 3 mm accuracy.

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“…Throughout the procedure, real-time image acquisition with MR protocols optimized for feature tracking are collected for motion compensation. It has been shown that liver motion is primarily due to respiration and has dominant motion components in the cranial-caudal and anterior-posterior directions and less motion in the left-right direction [4,5,6]. While the liver mostly behaves as a rigid body [7,8], non-rigid motion is non-negligible [5] and should be handled for accurate target tracking.…”

Section: Methodsmentioning

confidence: 99%

Real-Time Liver Motion Compensation for MRgFUS

Ross

Tranquebar

Shanbhag

2008

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008

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MR-guided focused ultrasound (MRgFUS) is a non-invasive method by which tissue is ablated using ultrasound energy focused on a point. The procedure has proven effective for stationary targets (e.g. uterine fibroids) but has not yet been used for liver lesion treatment due to organ motion. We describe a method to compensate for organ motion to enable continuous application of ultrasound energy in the presence of target movement in the liver. The method involves tracking several salient features (typically blood vessels) in the vicinity of the target location. The location of the target point(s) themselves are updated using a thin plate spline (TPS) interpolation scheme. We demonstrate sub-pixel tracking accuracy on synthetic sequences and additionally show results on MRI sequences acquired on human subjects. Per-feature tracking times were measured to be 5.7ms with a standard deviation of 1.6ms, sufficient for real-time use.

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Liver Motion Due to Needle Pressure, Cardiac, and Respiratory Motion During the TIPS Procedure

Cited by 11 publications

References 9 publications

3D/2D Model-to-Image Registration Applied to TIPS Surgery

3D/2D Model-to-Image Registration Applied to TIPS Surgery

Vessel target location estimation during the TIPS procedure

Real-Time Liver Motion Compensation for MRgFUS

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