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PelVis: Atlas-based Surgical Planning for Oncological Pelvic Surgery

Noeska Smit, Kai Lawonn, Annelot Kraima, Marco DeRuiter, Hessam Sokooti, Stefan Bruckner, Elmar Eisemann, Anna Vilanova

JOURNAL ARTICLE: IEEE Transactions on Visualization and Computer Graphics, vol. 23, no. 1, pp. 741–750, 2017. DOI: 10.1109/TVCG.2016.2598826

Abstract

Due to the intricate relationship between the pelvic organs and vital structures, such as vessels and nerves, pelvic anatomy is often considered to be complex to comprehend. In oncological pelvic surgery, a trade-off has to be made between complete tumor resection and preserving function by preventing damage to the nerves. Damage to the autonomic nerves causes undesirable post-operative side-effects such as fecal and urinal incontinence, as well as sexual dysfunction in up to 80 percent of the cases. Since these autonomic nerves are not visible in pre-operative MRI scans or during surgery, avoiding nerve damage during such a surgical procedure becomes challenging. In this work, we present visualization methods to represent context, target, and risk structures for surgical planning. We employ distance-based and occlusion management techniques in an atlas-based surgical planning tool for oncological pelvic surgery. Patient-specific pre-operative MRI scans are registered to an atlas model that includes nerve information. Through several interactive linked views, the spatial relationships and distances between the organs, tumor and risk zones are visualized to improve understanding, while avoiding occlusion. In this way, the surgeon can examine surgically relevant structures and plan the procedure before going into the operating theater, thus raising awareness of the autonomic nerve zone regions and potentially reducing post-operative complications. Furthermore, we present the results of a domain expert evaluation with surgical oncologists that demonstrates the advantages of our approach.

Published

IEEE Transactions on Visualization and Computer Graphics

  • Volume: 23
  • Number: 1
  • Pages: 741–750
  • Event: IEEE SciVis 2016
  • Location: Baltimore, USA
  • Date: January 2017
  • DOI: 10.1109/TVCG.2016.2598826

Documents and Links

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BibTeX

@ARTICLE{Smit-2017-PAS,
  author = {Noeska Smit and Kai Lawonn and Annelot Kraima and Marco DeRuiter
	and Hessam Sokooti and Stefan Bruckner and Elmar Eisemann and Anna
	Vilanova},
  title = {PelVis: Atlas-based Surgical Planning for Oncological Pelvic Surgery},
  journal = {IEEE Transactions on Visualization and Computer Graphics},
  year = {2017},
  volume = {23},
  pages = {741--750},
  number = {1},
  month = jan,
  abstract = {Due to the intricate relationship between the pelvic organs and vital
	structures, such as vessels and nerves, pelvic anatomy is often considered
	to be complex to comprehend. In oncological pelvic surgery, a trade-off
	has to be made between complete tumor resection and preserving function
	by preventing damage to the nerves. Damage to the autonomic nerves
	causes undesirable post-operative side-effects such as fecal and
	urinal incontinence, as well as sexual dysfunction in up to 80 percent
	of the cases. Since these autonomic nerves are not visible in pre-operative
	MRI scans or during surgery, avoiding nerve damage during such a
	surgical procedure becomes challenging. In this work, we present
	visualization methods to represent context, target, and risk structures
	for surgical planning. We employ distance-based and occlusion management
	techniques in an atlas-based surgical planning tool for oncological
	pelvic surgery. Patient-specific pre-operative MRI scans are registered
	to an atlas model that includes nerve information. Through several
	interactive linked views, the spatial relationships and distances
	between the organs, tumor and risk zones are visualized to improve
	understanding, while avoiding occlusion. In this way, the surgeon
	can examine surgically relevant structures and plan the procedure
	before going into the operating theater, thus raising awareness of
	the autonomic nerve zone regions and potentially reducing post-operative
	complications. Furthermore, we present the results of a domain expert
	evaluation with surgical oncologists that demonstrates the advantages
	of our approach.},
  doi = {10.1109/TVCG.2016.2598826},
  event = {IEEE SciVis 2016},
  keywords = {atlas, surgical planning, medical visualization},
  location = {Baltimore, USA},
}






 Last Modified: Stefan Bruckner, 2017-06-14