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Workflow oriented software support for image-guided radiofrequency ablation of focal liver malignancies

: Weihusen, A.; Ritter, F.; Kröger, T.; Preusser, T.; Zidowitz, S.; Peitgen, H.-O.


Cleary, K.R. ; American Association of Physicists in Medicine -AAPM-; Society of Photo-Optical Instrumentation Engineers -SPIE-, Bellingham/Wash.:
Medical imaging 2007 - Visualization and image-guided procedures. Vol.1 : 18 - 20 February 2007, San Diego, California, USA
Bellingham, WA: SPIE, 2007 (SPIE Proceedings Series 6509)
ISBN: 978-0-8194-6627-3
ISSN: 0277-786X
ISSN: 1605-7422
Paper 650919
Conference "Medical Imaging" <2007, San Diego/Calif.>
Fraunhofer MEVIS ()
liver; radiofrequency ablation; software; visualization

Image guided radiofrequency (RF) ablation has taken a significant part in the clinical routine as a minimally invasive method for the treatment of focal liver malignancies. Medical imaging is used in all parts of the clinical workflow of an RF ablation, incorporating treatment planning, interventional targeting and result assessment. This paper describes a software application, which has been designed to support the RF ablation workflow under consideration of the requirements of clinical routine, such as easy user interaction and a high degree of robust and fast automatic procedures, in order to keep the physician from spending too much time at the computer. The application therefore provides a collection of specialized image processing and visualization methods for treatment planning and result assessment. The algorithms are adapted to CT as well as to MR imaging. The planning support contains semi-automatic methods for the segmentation of liver tumors and the surrounding vascular system as well as an interactive virtual positioning of RF applicators and a concluding numerical estimation of the achievable heat distribution. The assessment of the ablation result is supported by the segmentation of the coagulative necrosis and an interactive registration of pre- and post-interventional image data for the comparison of tumor and necrosis segmentation masks. An automatic quantification of surface distances is performed to verify the embedding of the tumor area into the thermal lesion area. The visualization methods support representations in the commonly used orthogonal 2D view as well as in 3D scenes.