The Experimental And Clinical Research Of Three-dimensional Navigation About Liver Tumor Ablation

Text：Image guided ablation therapy is an effective method for the treatmentof solid tumors. Although the guidance of two-dimensional image obtainedremarkable achievements, there are many deficiencies. The appearance ofthree-dimensional image navigation promotes the image guided ablation toreach a new level. Therefore, this thesis proposed three-dimensional imagenavigation technology, studied the key technique of three-dimensional imagenavigation, applied three-dimensional image navigation technique for clinic andachieved satisfactory efficacy.In this paper, the main work is as follows:1. The calibration of ultrasonic probe. The new method of ultrasonic probecalibration has been successfully established through self-made "N" typewire frame phantoms. The displacement parameters of Tx, Ty, Tz and therotation parameters of Rα, Rβ, Rγ has been obtained. This calibration hasbeen proved to have a high precision through the self-made rigid model No.1. This section could be the foundation for the real-time three-dimensionalimage navigation.2. The basic technology of three-dimensional navigation. The tip of microwavehas been calibrated onto virtual three-dimensional microwave antenna imageand could be displayed real-time. The average error of three-dimensionalnavigation has been verified about0.52mm±0.389by using rigid model No.2. The accuracy rate of puncturing8~14mm focus in CIRS standard analogabdominal phantom guided by three-dimensional navigation was91.43%.This section built the foundation of three-dimensional navigation applicationfor clinic.3. Clinical study of the image fusion. Body surface fiducials registrationmethod and internal fiducials registration method were compared by thepaired clinical experiment. The experimental objects were liver tumors in patients. The fusion images contained ultrasonography and CT image. Themean error of body surface fiducials registration method was8.9mm±4.15,while internal fiducials registration method was7.58mm±3.88, P＜0.05.The average time of the body surface fiducials registration method was195s±43.55, while internal fiducials registration method was457.62s±290.81, P＜0.05. Internal fiducials registration method has more accuracy than bodysurface fiducials registration method, but long time consumed.4. Clinical study of three-dimensional image navigation guided ablationtherapy. The first segment, three-dimensional image navigation has beensuccessfully used for guiding microwave ablation to therapy unclear orincomplete primary liver cancer on ultrasound in13patients with15nodules.The first course successful ablation rate was80%, local tumor progressionrate was7.1%. The use of three-dimensional image navigation technologyfor unclear or incomplete lesion on ultrasound is feasible, safety, andeffective. The second segment, a prospective, non randomized cohort studyhas been designed to compare the space disposal of microwave antennabetween three-dimensional image navigation group and ultrasound guidedgroup to therapy hepatocellular carcinoma. The first course successfulablation rate of three-dimensional image navigation group was8.3%, whileultrasound group was37%, P＜0.05. The average time of disposal eachantenna in three-dimensional image navigation group was300.5s±46.53,while ultrasound group was521.04±143.91, P＜0.05. Thethree-dimensional image navigation technique can improve the efficacy ofmicrowave antenna space disposal and shorten each antenna disposal time.Conclusion: Three-dimensional image navigation technology with rich spaceinformation has high accuracy. For guiding microwave ablation ofhepatocellular carcinoma, three-dimensional image navigation is feasible, safe,effective, and can improve the effectiveness of needle placement, shortenaverage time of needle placement.