ROI-Based Intraoperative MR-CT Registration for Image-Guided Multimode Tumor Ablation Therapy in Hepatic Malignant Tumors

Panlong Xu,Jianqi Sun,Xinyi Wang,Wentao Li,Chao Chen

doi:10.1109/access.2020.2966518

Panlong Xu, Jianqi Sun + Show 3 more

Open Access

https://doi.org/10.1109/access.2020.2966518

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Abstract

Image-guided ablation therapy has been widely used as a minimally invasive treatment for hepatic malignant tumors. Image registration is very useful during such operations, especially for multimode tumor ablation therapy. This research proposes a novel idea for performing MR-CT registration in multimode tumor ablation therapy based on liver segmentation. First, the liver is segmented from the preoperative 3D MR image and the intraoperative 3D CT image using a deep learning method based on a modified UNet++ architecture. Then, the preoperative MR image and the intraoperative CT image are coregistered using rigid and nonrigid registration methods with the segmented liver as the region of interest. The segmented binary images, rather than gray-level images, are aligned in the rigid registration step, which proves to be faster and more accurate than the registration method based on gray information. For the nonrigid registration, a multilevel free-form deformation method is applied to correct tiny misalignments. Finally, our method was validated using clinical data from 15 patients. The proposed method achieved an average Dice coefficient and target registration error of 93.36±1.21% and 4.42±2.35 mm, respectively, and it can help interventional radiologists adjust the probe position in clinical work.

Highlights

Hepatic cancer is one of the most dangerous diseases in China [1]
We proposed a new idea for registering the preoperative MR image and intraoperative CT image that takes the liver as the ROI, this method proves to have great efficiency and accuracy and can be applied in clinics in the future
This research aims to provide a fast, accurate and robust registration method to assist interventional physicians in estimating and adjusting the position of the ablation probe during a multimode hepatic malignant tumor ablation surgery guided by CT imaging

Summary

Introduction

Hepatic cancer is one of the most dangerous diseases in China [1]. To cure this disease, various methods have been proposed and are mainly divided into four categories: (1) surgical resection, (2) radiation therapy, (3) chemotherapy, and (4) ablation therapy, which is widely used because it is minimally invasive, low-cost and easy to perform.At present, the widely used thermophysical ablation techniques in clinical practice are radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA) and cryoablation, which are based on high-temperature coagulation or low-temperature freezing. Hepatic cancer is one of the most dangerous diseases in China [1]. To cure this disease, various methods have been proposed and are mainly divided into four categories: (1) surgical resection, (2) radiation therapy, (3) chemotherapy, and (4) ablation therapy, which is widely used because it is minimally invasive, low-cost and easy to perform. The widely used thermophysical ablation techniques in clinical practice are radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA) and cryoablation, which are based on high-temperature coagulation or low-temperature freezing. Based on the above research, our team innovatively combined cryotherapy, radiofrequency ablation therapy, and thermophysical immunotherapy, and we proposed multimode ablation therapy for the first time

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