Intra-operative visualisation of 3D temperature maps and 3D navigation during tissue cryoablation

Abstract

Thermotherapeutic tools are increasingly used for tissue ablation, although the intra-operative monitoring is not adequate for such procedures. This is a main challenge for more extensive use of any ablative technique. The present work focuses on treatment of hepatic tumours by cryo therapy. For any thermotherapeutic tool there are specific thermal conditions that have to be met to ensure treatment adequacy. A software tool was made to calculate and visualise 3D temperature distributions during hepatic cryoablation combined with a 3D intra-operative navigation system. This system aids the user in placing the cryoprobe using an optical tracking system and 3D visualisation of the probe placement in relation to the target anatomy and the planned trajectory. 3D temperature distributions are calculated and visualized intra-operatively. The system is integrated with an interventional Magnetic Resonance 0.5T scanner. The system was tested in an animal experiment, exemplifying the usefulness of the navigation system and its ability to give intuitive feedback to the user on thermodynamic conditions induced in the target region. The system constitutes a novel tool for enhanced intra-operative control during cryoablative procedures, and motivates for studies using this tool to investigate predictors applied as indicators of treatment adequacy and patient outcome.