Purpose
The initial registration of a 3D pre-operative CT model to a 2D laparoscopic video image in augmented reality systems for liver surgery needs to be fast, intuitive to perform and with minimal ...interruptions to the surgical intervention. Several recent methods have focussed on using easily recognisable landmarks across modalities. However, these methods still need manual annotation or manual alignment. We propose a novel, fully automatic pipeline for 3D–2D global registration in laparoscopic liver interventions.
Methods
Firstly, we train a fully convolutional network for the semantic detection of liver contours in laparoscopic images. Secondly, we propose a novel contour-based global registration algorithm to estimate the camera pose without any manual input during surgery. The contours used are the anterior ridge and the silhouette of the liver.
Results
We show excellent generalisation of the semantic contour detection on test data from 8 clinical cases. In quantitative experiments, the proposed contour-based registration can successfully estimate a global alignment with as little as 30% of the liver surface, a visibility ratio which is characteristic of laparoscopic interventions. Moreover, the proposed pipeline showed very promising results in clinical data from 5 laparoscopic interventions.
Conclusions
Our proposed automatic global registration could make augmented reality systems more intuitive and usable for surgeons and easier to translate to operating rooms. Yet, as the liver is deformed significantly during surgery, it will be very beneficial to incorporate deformation into our method for more accurate registration.
Purpose
Image-guidance systems have the potential to aid in laparoscopic interventions by providing sub-surface structure information and tumour localisation. The registration of a preoperative 3D ...image with the intraoperative laparoscopic video feed is an important component of image guidance, which should be fast, robust and cause minimal disruption to the surgical procedure. Most methods for rigid and non-rigid registration require a good initial alignment. However, in most research systems for abdominal surgery, the user has to manually rotate and translate the models, which is usually difficult to perform quickly and intuitively.
Methods
We propose a fast, global method for the initial rigid alignment between a 3D mesh derived from a preoperative CT of the liver and a surface reconstruction of the intraoperative scene. We formulate the shape matching problem as a quadratic assignment problem which minimises the dissimilarity between feature descriptors while enforcing geometrical consistency between all the feature points. We incorporate a novel constraint based on the liver contours which deals specifically with the challenges introduced by laparoscopic data.
Results
We validate our proposed method on synthetic data, on a liver phantom and on retrospective clinical data acquired during a laparoscopic liver resection. We show robustness over reduced partial size and increasing levels of deformation. Our results on the phantom and on the real data show good initial alignment, which can successfully converge to the correct position using fine alignment techniques. Furthermore, since we can pre-process the CT scan before surgery, the proposed method runs faster than current algorithms.
Conclusion
The proposed shape matching method can provide a fast, global initial registration, which can be further refined by fine alignment methods. This approach will lead to a more usable and intuitive image-guidance system for laparoscopic liver surgery.
Next generation sequencing (NGS) is a technology that broadens the horizon of knowledge of several somatic pathologies, especially in oncological and oncohematological pathology. In the case of NHL, ...the understanding of the mechanisms of tumorigenesis, tumor proliferation and the identification of genetic markers specific to different lymphoma subtypes led to more accurate classification and diagnosis. Similarly, the data obtained through NGS allowed the identification of recurrent somatic mutations that can serve as therapeutic targets that can be inhibited and thus reducing the rate of resistant cases. The article’s purpose is to offer a comprehensive overview of the best ways of integrating of next-generation sequencing technologies for diagnosis, prognosis, classification, and selection of optimal therapy from the perspective of tailor-made medicine.
Background. The impact of SARS-CoV-2 infection alongside with influenza and RSV, the major viral agents in pediatric disordes, may be an important concern to the healthcare system. Clinical outcomes ...of the interaction are unknown. The aim of this systematic review is to contribute at establishing the prevalence of the co-infection, its clinical outcomes and potential risk factors. Methods. A systematical literature search was performed for papers published in PubMed, Scopus, Web of Science, Pedro and Cochrane Library, from January 2020 - the beginning of the COVID 19 pandemic - to June 2023. Our review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Studies were eligible for inclusion if they approached the co-infection COVID 19 and influenza or RSV, and were available in English. Due to the fact that studies conducted on pediatric population are scarce, we included patients of all ages. Results. Out of 159 articles found, 12 were eligible for inclusion. The prevalence of co-infection was between 5% and 12 % for influenza viruses and 10% for RSV. The most common symptoms were high-grade fever, cough, headache, and shortness of breath and the most frequent complications were pneumonia and respir-atory distress. In terms of laboratory findings, co-infected patients presented with signifi-cant lymphopenia and pronounced inflammatory response, as well as a progressive ten-dency towards pneumonia and respiratory distress. Regarding the clinical outcomes of co-infection, the majority of articles indicated that simultaneous infection with SARS-CoV-2 and influenza predisposes to a more severe course of the disease(s), with a longer length of hospital stay and an increased risk of death.Conclusion. Our study underlines that the frequency of such co-infections, although not very high, predisposes to more frequent hos-pitalisations and a longer length of stay, complications including admission to intensive care and more severe outcomes, including life-threatening events. It is therefore essential to determine the epidemiological impact of such an interaction nowadays, in order to in-form and adjust treatment and control and prevention strategies, for limiting co-infection between major respiratory viruses. Due to the lack of studies on children, we were unable to identify specific features of co-infections in this population. Therefore, more studies are needed to evaluate the paediatric population and consequently, our doctoral research en-deavour is warranted.
Non-Hodgkin's lymphomas (NHL) are malignant tumors that develop from lymphoid tissue. They are one of the most common malignancies and they represent one of the most complicated problems of ...oncohematology. The age group that is mostly affected by NHL in the Republic of Moldova is the patients over 60 years, and the disorder in most cases starts in lymph nodes. This study aims to determine the particularities of elderly patients with NHL with primary involvement of peripheral lymph nodes(l/n).
A retrospective study of a group of 78 NHL patients with primary lymph node involvement was performed. The average age of study participants ranged from 60 to 84 years.
NHL more often developed primarily in the peripheral l/n (84.7%), less frequently in the mediastinal l/n (6.4%) and abdominal l/n(8.9%). Aggressive NHL predominated (59.0%), but indolent NHL also developed quite frequently (41.0%), which were more frequent in cases of primary affection to the cervical l/n (47.4%), inguinal l/n(41.7%), and abdominal l/n(42.9%). The 5-year survival of NHL patients with primary lymph node involvement aged over 60 years was low and amounted to 31.2%;
NHL occurred more often in the peripheral lymph nodes (84.7%), less frequently in the mediastinum (6.4%), and abdominal lymph nodes (8.9%). The frequency of aggressive NHL was 59.0%. Indolent NHL was diagnosed in 41% of cases. The 5-year survival rate in the study group constitutes 31,2%, lower compared with younger patients treated in the same center.
ANTICARDIOLIPINIC ANTIBODIES IN NON-HODGKIN LYMPHOMA Buruiana, Sanda; Mazur, Minodora; Robu, Maria ...
Hematology, Transfusion and Cell Therapy,
November 2021, 2021-11-00, 2021-11-01, Letnik:
43
Journal Article
Recenzirano
Odprti dostop
Identification of hemostasis changes in patients with non-Hodgkin's lymphoma (NHL) and anticardiolipin antibodies (aCL).
The study included 83 patients (men-34, women-49) with a mean age of 63.2 ...years, with NHL, investigated complex, by research of lupus anticoagulant (LA) by Turbidimetry; antiβ2glycoprotein I IgG, IgM and aCL antibodies, by ELISA method. Hemostasis disorders were evaluated according to the type of NHL, stage, tumor size.
aCL were detected in 10 (12%) patients: 6 patients with aggressive type lymphoma and 4 patients with indolent type lymphoma, with advanced stage B cell NHL in 60%, mean age 52.8 years. LA was present in 80% of cases, unlike aCL IgG antibodies (10%) and antiβ2glycoprotein I IgG (10%). Hemostasis disorders were found in 6 (60%) patients: thrombotic events-at 4 (40%) patients with Mantle cell lymphoma (1 patient), Small lymphocytic lymphoma (1 patient), lymphoblastic lymphoma (2 patients). Local stage (I and II) of the lymphoma was in 75%, but with a large size of the tumor (> 11 cm), and hemorrhage at 2 (20%) patients with stage IV Small lymphocytic lymphoma, in which immune thrombocytopenia developed.
The presence of antiphospholipid antibodies, in particular of lupus anticoagulant, advanced age, generalized stage, and large tumor size are risk factors for the development of hemostasis diseases in NHL patients, especially thrombosis.
Purpose
Laparoscopic ultrasound (LUS) enhances the safety of laparoscopic liver resection by enabling real-time imaging of internal structures such as vessels. However, LUS probes can be difficult to ...use, and many tumours are iso-echoic and hence are not visible. Registration of LUS to a pre-operative CT or MR scan has been proposed as a method of image guidance. However, the field of view of the probe is very small compared to the whole liver, making the registration task challenging and dependent on a very accurate initialisation.
Methods
We propose the use of a subject-specific planning framework that provides information on which anatomical liver regions it is possible to acquire vascular data that is unique enough for a globally optimal initial registration. Vessel-based rigid registration on different areas of the pre-operative CT vascular tree is used in order to evaluate predicted accuracy and reliability.
Results
The planning framework is tested on one porcine subject where we have taken 5 independent sweeps of LUS data from different sections of the liver. Target registration error of vessel branching points was used to measure accuracy. Global registration based on vessel centrelines is applied to the 5 datasets. In 3 out of 5 cases registration is successful and in agreement with the planning. Further tests with a CT scan under abdominal insufflation show that the framework can provide valuable information in all of the 5 cases.
Conclusions
We have introduced a planning framework that can guide the surgeon on how much LUS data to collect in order to provide a reliable globally unique registration without the need for an initial manual alignment. This could potentially improve the usability of these methods in clinic.
Purpose
Minimally invasive surgery offers advantages over open surgery due to a shorter recovery time, less pain and trauma for the patient. However, inherent challenges such as lack of tactile ...feedback and difficulty in controlling bleeding lower the percentage of suitable cases. Augmented reality can show a better visualisation of sub-surface structures and tumour locations by fusing pre-operative CT data with real-time laparoscopic video. Such augmented reality visualisation requires a fast and robust video to CT registration that minimises interruption to the surgical procedure.
Methods
We propose to use view planning for efficient rigid registration. Given the trocar position, a set of camera positions are sampled and scored based on the corresponding liver surface properties. We implement a simulation framework to validate the proof of concept using a segmented CT model from a human patient. Furthermore, we apply the proposed method on clinical data acquired during a human liver resection.
Results
The first experiment motivates the viewpoint scoring strategy and investigates reliable liver regions for accurate registrations in an intuitive visualisation. The second experiment shows wider basins of convergence for higher scoring viewpoints. The third experiment shows that a comparable registration performance can be achieved by at least two merged high scoring views and four low scoring views. Hence, the focus could change from the acquisition of a large liver surface to a small number of distinctive patches, thereby giving a more explicit protocol for surface reconstruction. We discuss the application of the proposed method on clinical data and show initial results.
Conclusion
The proposed simulation framework shows promising results to motivate more research into a comprehensive view planning method for efficient registration in laparoscopic liver surgery.
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