Visually Supporting Multiple Needle Placement in Irreversible Electroporation Interventions

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Date
2018
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© 2018 The Eurographics Association and John Wiley & Sons Ltd.
Abstract
Irreversible electroporation (IRE) is a minimally invasive technique for small tumour ablation. Multiple needles are inserted around the planned treatment zone and, depending on the size, inside as well. An applied electric field triggers instant cell death around this zone. To ensure the correct application of IRE, certain criteria need to be fulfilled. The needles' placement in the tissue has to be parallel, at the same depth, and in a pattern which allows the electric field to effectively destroy the targeted lesions. As multiple needles need to synchronously fulfill these criteria, it is challenging for the surgeon to perform a successful IRE. Therefore, we propose a visualization which exploits intuitive visual coding to support the surgeon when conducting IREs. We consider two scenarios: first, to monitor IRE parameters while inserting needles during laparoscopic surgery; second, to validate IRE parameters in post‐placement scenarios using computed tomography. With the help of an easy to comprehend and lightweight visualization, surgeons are enabled to quickly visually detect what needs to be adjusted. We have evaluated our visualization together with surgeons to investigate the practical use for IRE liver ablations. A quantitative study shows the effectiveness compared to a single 3D view placement method.Irreversible electroporation (IRE) is a minimally invasive technique for small tumour ablation. Multiple needles are inserted around the planned treatment zone and, depending on the size, inside as well. An applied electric field triggers instant cell death around this zone. To ensure the correct application of IRE, certain criteria need to be fulfilled. The needles' placement in the tissue has to be parallel, at the same depth, and in a pattern which allows the electric field to effectively destroy the targeted lesions. As multiple needles need to synchronously fulfill these criteria, it is challenging for the surgeon to perform a successful IRE. Therefore, we propose a visualization which exploits intuitive visual coding to support the surgeon when conducting IREs. We consider two scenarios: first, to monitor IRE parameters while inserting needles during laparoscopic surgery; second, to validate IRE parameters in post‐placement scenarios using computed tomography. With the help of an easy to comprehend and lightweight visualization, surgeons are enabled to quickly visually detect what needs to be adjusted.
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@article{
10.1111:cgf.13311
, journal = {Computer Graphics Forum}, title = {{
Visually Supporting Multiple Needle Placement in Irreversible Electroporation Interventions
}}, author = {
Kreiser, J.
and
Freedman, J.
and
Ropinski, T.
}, year = {
2018
}, publisher = {
© 2018 The Eurographics Association and John Wiley & Sons Ltd.
}, ISSN = {
1467-8659
}, DOI = {
10.1111/cgf.13311
} }
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