Preoperative SPECT/CT + intraoperative CT fusion enabling surgical augmented reality to target sentinel lymph node in endometrial cancer.
Journal
EJNMMI physics
ISSN: 2197-7364
Titre abrégé: EJNMMI Phys
Pays: Germany
ID NLM: 101658952
Informations de publication
Date de publication:
22 Nov 2022
22 Nov 2022
Historique:
received:
08
04
2022
accepted:
31
10
2022
entrez:
22
11
2022
pubmed:
23
11
2022
medline:
23
11
2022
Statut:
epublish
Résumé
To establish a proof-of-concept study using a phantom model to allow the fusion of preoperative single-photon emission computed tomography (SPECT) combined with computed tomography (CT), also known as SPECT/CT, with intraoperative CT, enabling the application of an augmented reality (AR) surgical guidance system for pelvic sentinel lymph node (SLN) detection in endometrial cancer patients. A three-dimensional (3D) pelvic phantom model printed in a gelatin-based scaffold including a radiopaque pelvis, a vascular tree mimicking the iliac vessels, two 3D-printed fillable spheres representing the target pelvic sentinel lymph nodes, and a calibration board was developed. A planar with SPECT/CT lymphoscintigraphy and CT were performed independently on the model. We performed all the necessary steps to achieve the fusion between SPECT/CT and CT. Then, we performed a laparoscopy of the pelvic anatomy on the phantom model to assess in real time the overlay of the recording on the anatomical structures and AR guidance system performance. We have successfully completed all the steps needed to fuse the two imaging procedures. This allowed us to apply, in real time, our surgical guidance system with the coverage rate of the visible surface by the augmented reality surface, respectively, on the left SLN 99.48% and on the right SLN 99.42%. Co-registration and real-time fusion between a preoperative SPECT/CT and intraoperative CT are feasible. The metric performance of our guidance system is excellent in relation to possible SPECT/CT and CT fusion. Based on our results, we are able to translate the technology to patients, and we initiated a clinical study to evaluate the accuracy of the AR guidance system for endometrial cancer surgery, with a correlation with indocyanine green (ICG)-based technique, representing the gold standard today in the intraoperative detection of SLN in endometrial cancers, despite various limitations.
Identifiants
pubmed: 36414716
doi: 10.1186/s40658-022-00506-7
pii: 10.1186/s40658-022-00506-7
pmc: PMC9681940
doi:
Types de publication
Journal Article
Langues
eng
Pagination
81Subventions
Organisme : Plan Investissements d'Avenir" and the ANR
ID : ANR-10-IAHU-02
Informations de copyright
© 2022. The Author(s).
Références
J Surg Oncol. 2020 Mar;121(4):599-604
pubmed: 31994195
EJNMMI Res. 2021 Dec 14;11(1):123
pubmed: 34905122
Int J Gynecol Cancer. 2019 Mar;29(3):513-517
pubmed: 30833439
Med Hypotheses. 2012 Dec;79(6):858-63
pubmed: 23036905
Int J Gynecol Cancer. 2021 Jan;31(1):12-39
pubmed: 33397713
Neuroimage. 2006 Jul 1;31(3):1116-28
pubmed: 16545965
Gynecol Oncol. 2018 Mar;148(3):491-498
pubmed: 29273307
Magn Reson Imaging. 2012 Nov;30(9):1323-41
pubmed: 22770690
Gynecol Oncol. 2019 Jun;153(3):500-504
pubmed: 30902369
Ann Surg Oncol. 2016 Feb;23(2):450-5
pubmed: 26438438
Ann Nucl Med. 2017 Jan;31(1):93-99
pubmed: 27815812
Int J Gynecol Cancer. 2020 Mar;30(3):346-351
pubmed: 31911534
Eur J Nucl Med Mol Imaging. 2017 Aug;44(9):1511-1519
pubmed: 28374119
Int J Gynecol Cancer. 2020 May;30(5):626-630
pubmed: 32200352