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Computerized Planning of Cryosurgery

 

Cryosurgery has been known as an invasive surgical technique since 1961, when Cooper and Lee invented the first cryoprobe. In the 1990s, new developments in Joule-Thomson cooling (the cooling effect associated with a sudden relief of a pressurized gas) led to a dramatic decrease in the size of cryoprobes and an increase in the number of cryoprobes that could be used simultaneously. A dozen or more cryoprobes operating simultaneously in a single prostate cryosurgery is already common practice. If localized effectively, one of the primary benefits of using a large number of miniaturized cryoprobes is superior control over the freezing process.

 

Currently, the process of selecting the correct placement of the cryoprobes for a specific procedure is an art held by the cryosurgeon, based on the surgeon’s own experience and rules of thumb. Cryoprobes are typically operated in a trail-and-error fashion, until the entire target volume is thought to be frozen. Currently, there are no means to determine the optimal locations for the cryoprobes. Suboptimal cryoprobe localization may leave regions in the target volume unfrozen, may lead to cryoinjury of healthy surrounding tissues, may require an unnecessarily large number of cryoprobes, may increase the duration of the surgical procedure, and may increase the likelihood of post cryosurgery complications, all of which affect the quality and cost of the medical treatment. Computerized planning tools would help to alleviate these difficulties.

 

Our goal is to develop computerized planning tools for cryosurgery that are suitable for all available cooling techniques. Towards this goal, we have developed two algorithms for computer-generated planning of minimally invasive cryosurgery, known as the force-field analogy method and the bubble-packing method.

 

Selected animated movies on the process of computer-generated planning:

       Computerized planning of cryosurgery via bubble packing (movies) 

       Computerized Planning: insertion-depth effect (movies) 

 

Selected publications on computerized planning of cryosurgery:

       Sehrawat, A., Keelan, R., Shimada, K., Wilfong, D.M., McCormick, J.T., Rabin, Y. (2015): Simulation-based cryosurgery intelligent tutoring system (ITS) prototype, Technology in Cancer Research and Treatment, in press PubMed

       Keelan, R., Zhang, H., Shimada, K., Rabin, Y. (2015):  GPU-based bioheat simulation to facilitate rapid decision making associated with cryosurgery training, Technology in Cancer Research and Treatment, in press PubMed

       Keelan, R., Yamakawa, S., Shimada, K., Rabin, Y. (2013): Computerized Training of cryosurgery – a system approach, CryoLetters 34(4):324-337 PubMed

       Rossi, M.R., Tanaka, D., Shimada, K., Rabin, Y. (2010): Computerized planning of prostate cryosurgery using variable cryoprobe insertion depth. Cryobiology 60(1):71-79 PubMed

       Rabin, Y. (2009): Computerized planning of cryosurgery: from model reconstruction to cryoprobe placement strategies. BiOS 2009, Energy-based Treatment of Tissue and Assessment V, San Jose, CA, USA (January 24-29) Download

       Rossi, M.R., Tanaka, D., Shimada, K., Rabin, Y. (2008): Computerized planning of cryosurgery using bubble packing: an experimental validation on a phantom material. International Journal of Heat and Mass Transfer 51(23-24):5671-5678 Download

       Tanaka, D., Shimada, K., Rossi, M.R., Rabin, Y. (2008): Computerized planning of prostate cryosurgery with pullback procedure. Computer Aided Surgery, 13(1):1-13 PubMed

       Tanaka, D., Shimada, K., Rossi, M.R., Rabin, Y. (2008): Cryosurgery planning using bubble packing in 3D. Computer Methods in Biomechanics and Biomedical Engineering, 11(2):113-121 Download

       Rabin, Y. (2008): Key issues in bioheat transfer simulations for the application of cryosurgery planning. Cryobiology, 56(3):248-50 Download

       Rossi, M.R., Tanaka, D., Shimada, K., Rabin, Y. (2007): An efficient numerical technique for bioheat simulations and its application to computerized cryosurgery planning. Computer Methods and Programs in Biomedicine, 85(1):41-50 Download

       Tanaka, D., Rossi, M.R., Shimada, K., Rabin, Y. (2007): Towards intra-operative computerized planning of prostate cryosurgery. The International Journal of Medical Robotics and Computer Assisted Surgery, 3:10-19 Download

       Rossi, M.R., Rabin, Y. (2007): Experimental verification of numerical simulations of cryosurgery with application to computerized planning. Physics in Medicine and Biology 52:4553-4567 Download

       Tanaka, D., Shimada, K., Rabin, Y. (2006): Two-phase Computerized Planning of Cryosurgery Using Bubble-packing and Force-field Analogy. ASME Journal of Biomechanical Engineering, 128(1):49-58 Download

       Lung, D.C., Stahovich, T.F., Rabin, Y. (2004): Computerized planning for multiprobe cryosurgery using a force-field analogy. Computer Methods in Biomechanics and Biomedical Engineering, 7(2):101-110 Download

       Rabin, Y., Lung, D.C., Stahovich, T.F. (2004): Computerized planning of cryosurgery using cryoprobes and cryoheaters. Technology in Cancer Research and Treatment, 3(3):227-243. Download

 

 

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This research has been supported, in part, by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) NIH Grant # 1R01EB003563

 

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