Liver Surgery

Clinical Challenges

There are several risks during liver surgery, with liver failure being the most severe. Major risk factors include the volume of the remnant liver after surgery as well as the health of the remaining liver tissue. For oncologic resections, the tumor safety margin presents another risk and is a critical marker for cancer recurrence and the success of the surgery. Unfortunately, the goal of having a large safety margin around the tumor is contradictory to the aim of saving as much healthy liver tissue as possible, especially in the context of keeping the resection procedure simple. These risk factors, added to the complexity of the liver vasculature, motivated the development of a patient-specific, computer-assisted planning platform at Fraunhofer MEVIS.

 

Risk Analysis for Living Donor Liver Transplantations

Estimation of postoperative function based on a detailed analysis of vascular anatomy.

 

Planning of Tumor Resections

Model-based optimization of resection planning to avoid surgical risks.

 

Support in the Operating Room

Mobile Solution for the intraoperative guidance in soft tissue surgery which allows interactive, full access to patient data.

 

Liver and Tumor Segmentation

Fully automatic liver and tumor segmentation improves liver therapy planning.

Image-based Computation of Liver Function

Model-based analysis of DCE-MRI supports the evaluation of tumor vitality and tissue function.

 

Liver-specific contrast agents for MRI allow to determine vitality parameters by matching and analyzing image series. The resulting voxel-based values and parameter maps show local differences in tissue and tumor areas. They can be used for a more precise prediction of liver function than the volume alone.

 

Registration of Abdominal Images

The abdomen is strongly exposed to organ movement and deformation. Multi-modal image fusion, follow-up comparison, and intra-operative navigation benefit from deformable image registration.