Visually Supporting Multiple Needle Placement in Irreversible Electroporation Interventions

Julian Kreiser

Ulm University

Jacob Freedman

Timo Ropinski

Ulm University

Computer Graphics Forum 2017

Abstract

Irreversible electroporation (IRE) is a minimally invasive technique for small tumor 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 (CT). 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.

Bibtex

@article{kreiser2018ire,
	title={Visually Supporting Multiple Needle Placement in Irreversible Electroporation Interventions},
	author={Kreiser, Julian and Freedman, Jacob and Ropinski, Timo},
	year={2017},
	journal={Computer Graphics Forum},
	volume={37},
	pages={59--71},
	issue={6},
	doi={10.1111/cgf.13311}
}