研究主題 Researches

2021 使用改良式ICP追蹤技術開發應用於肝臟切除手術之MR訓練系統

肝癌的發病率和死亡率會隨著年齡的增長而增加,這在現今人口快速高齡化的趨勢中,肝癌相關醫療照護成為了急需面對的問題。肝臟切除手術為肝癌的主要治療方式,然而由於肝臟內部的血管結構複雜,臨床術前和術中規劃又僅能依靠CT 影像,其因缺乏3D 空間資訊,使得肝臟切除手術的成功與否相當仰賴醫師自身的經驗。有鑑於此,本研究提出一套使用改良式ICP 追蹤技術開發應用於肝臟切除手術之MR 訓練系統,系統可以區分為兩大部分。第一個部分是彈性肝臟假體的製作,提供臨床醫師在手術訓練時能有更真實的觸覺感受。在肝臟硬度值量測實驗中,本研究所製作的彈性肝臟假體平均硬度為18.8 DU,符合先前文獻所表明的肝癌患者的肝臟硬度範圍。第二個部分是利用改良式ICP 追蹤技術將3D 虛擬血管模型疊加至彈性肝臟假體上,且經由實驗結果顯示,在不同角度偏差情況下,本研究所提出的改良式ICP 演算法對位誤差皆 <4 mm。希望藉由本研究所提出應用於肝臟切除手術之MR 訓練系統,可以改善臨床醫師培訓成效,也可以作為未來其他應用之參考。
 
In the current trend of a rapidly aging population, medical care in relation to liver cancer has become an urgent issue. Liver resection is the main treatment method for liver cancer, and the internal anatomical structure of blood vessels is quite complex. In the preoperative and intraoperative planning, however, surgeons only can rely on CT images which lack of 3D spatial information, the success or failure of an operation depends on their own clinical experience. Therefore, this study proposed a development of a MR training system for liver resection surgery using modified ICP tracking technology, and it can be divided into two parts. The first part of this system introduced the fabrication of an elastic liver phantom that could provide clinicians with a realistic tactile sensation. In the measurement experiment on hardness of elastic liver phantom, the average hardness in this study was 18.8 DU, which is consistent with the liver hardness range of liver cancer patients from previous literature. In the second part, the 3D virtual vascular model was superimposed on the elastic liver phantom using a modified ICP tracking technology. The experiment result showed that the registration error with different angular deviations of the proposed modified ICP algorithm in this study was <4 mm. It is expected that the MR training system for liver resection surgery using modified ICP tracking technology can enhance the overall clinicians training effect and serve as a reference for other applications in the future.

許成彬