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Alternative TitleResearch and Applications of Surgical Navigation System with Optical Molecular Imaging Technology in Breast Cancer
Abstract手术过程中如何快速、准确、客观的定位肿瘤及其他病灶组织的边界一直是国际上的研究热点和挑战性问题。现有的医学影像技术在术前诊断与术后评估方面都发挥着重要的作用,然而适合外科医生进行术中成像的影像方法却难觅踪迹。随着影像学技术的发展,光学分子影像手术导航为该问题的解决提供了可能。光学分子影像是在活体状态下对生物过程进行分子细胞水平的定性和定量分析,实现对生物体早期生理、病理变化的无创、动态、连续、在体成像。与其他成像技术相比,具有灵敏度高、无放射性、结果直观、成像快速以及使用成本低等诸多优点,可以在病变早期实现在体成像。手术导航技术是一种在术中辅助临床医生对病变组织施行准确定位及对病灶区域实施精确切除的方法。光学分子影像手术导航可以针对早期及微小病变帮助医生在术中对病灶区域实施准确切除手术。 本文围绕如何进行乳腺癌的早期精确定位和准确切除,研发了光学分子影像手术导航系统,并开展了预临床及临床的应用验证。在验证的过程中,对如何进一步提高系统的鲁棒性及可靠性进行了研究,提出了系统的设计方法及构成,在开展临床实验前完成了预临床动物实验验证,根据动物实验结果设计了临床实验方案,在通过医院伦理审批的基础上,对百余例乳腺癌患者实施有效的诊疗。主要研究内容包含以下几点: 1、提出了一种基于光学分子影像的激发荧光多光谱成像方法。该方法根据光学分子影像的成像理论,对光学成像光路进行计算和设计,实现了在手术过程中对解剖结构图像及组织特异性图像的同时实时显示,方便医生精确定位病灶组织。实验测试结果证明该方法具有可靠性及稳定性。 2、提出了一种适合临床医生使用和操作的系统构架方法。该方法可以将系统支架进行空间任意角度的提拉和固定,使用过程不影响常规手术操作,同时通过系统的引导,将肿瘤及组织特异性信息反馈给外科医生,术中实施准确切除手术。实验结果及医生使用反馈表明该方法具有很好的鲁棒性和实用性。 3、验证了利用光学分子影像手术导航方法,检测早期乳腺癌原位肿瘤及其转移灶的预临床应用可行性。对比了利用光学分子影像手术导航的方法与传统凭借经验方法切除肿瘤的差异,说明利用光学分子影像手术导航的方法在术中切除乳腺癌肿瘤的特异性。对临床医生使用荧光染料的方法、剂量、浓度及持续时间加以研究,给出建议操作流程。实验结果证明该方法对乳腺癌术中检测具有很好的灵敏度和特异性。 4、验证了光学分子影像手术导航技术在检测乳腺癌早期前哨淋巴结的临床应用可行性,并与传统亚甲蓝方法进行了临床对比验证。统计分析了光学分子影像手术导航方法的检出率,以及与传统方法对比的检出率。实验结果证明该方法具有很好的准确性及临床应用价值。
Other AbstractIn recent years, how to quickly, accurately and objectively locate tumors and other lesions of the organization has been an internationally challenging issue for researchers. Existing medical imaging technology has played an important role in the preoperative diagnosis and postoperative assessment, however there are few methods designed for surgeons and suitable for intraoperative imaging. With the development of imaging techniques, surgical navigation technology with optical molecular imaging methods offers the potential to solve the problem. Optical molecular imaging is a method for imaging in a state of cellular levels in vivo quantitative and qualitative analysis. This method can be achieved on the organism early physiological and pathological changes in non-invasive, dynamic, continuous, in vivo imaging. Compared with other imaging techniques, molecular imaging method, which can be realized in early lesions in vivo imaging, take the advantage of high sensitivity, non-radioactivity, visualization results, real-time imaging and low cost. Surgical navigation technology is a method which can help surgeons intraoperatively accurately locate the tumor tissue and precisely resect the lesions. This paper focuses on how to accurately locate the breast cancer tissues with early stage diagnosis. The surgical navigation system with optical molecular imaging method has been developed and some pre-clinical and clinical applications have been carried out to prove its feasible usage. The research has mainly focus on how to further improve the robustness and reliability of our system and proposed the effective design for the system configuration. The main contents include the following points: 1. A multi-spectral imaging method based on the fluorescence molecular imaging has been proposed. With the design of optical molecular imaging method, it can be realized that the anatomical structure and tissue-specific images were real-time displayed during the surgery. Our experimental results show that this method has the reliability and stability for clinical usage. 2. According to the intraoperative convenience for surgeons to pinpoint the lesion tissue, a suitable architecture design method was proposed in our system for surgeons’ usage during surgery. This method can be adjusted to any angle within the space. And the operation process does not affect the use of the conventional surgical procedure. With the guidance of our system, tumor-specific images can be feedbac...
Keyword光学分子影像 手术导航 近红外荧光成像 乳腺癌 前哨淋巴结 Optical Molecular Imaging Surgical Navigation Near Infrared Fluorescence Imaging Breast Cancer Sentinel Lymph Nodes
Document Type学位论文
Recommended Citation
GB/T 7714
迟崇巍. 光学分子影像手术导航系统在乳腺癌方面的研究和应用[D]. 中国科学院自动化研究所. 中国科学院大学,2014.
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