3D Ultrasound Aids Cancer Surgery Imaging
Surgeons are tweaking existing computer technologies to enhance their visualization of cancerous tumors, according to a study presented at the 2014 American College of Surgeons Clinical Congress.

The research team tested the visualization of simulated breast tumors using 3D ultrasound imaging and augmented-reality software that allows the surgeon to pinpoint the tumor and measure its volume.

This high-tech imaging technique, according to its developers, is more accurate than standard methods.

Surgical oncologists usually remove breast cancers by relying on tactile feedback and radiologic images of the tumor, such as mammograms and ultrasound images, says M. Catherine Lee, MD, FACS, coauthor of the study and an associate professor of surgery at H. Lee Moffitt Cancer Center in Tampa, Florida.

Lee's team developed an imaging guidance system designed to minimize the need for repeated operations while sparing greater amounts of healthy breast tissue. Collaborating with Yanhui Guo, PhD, of St. Thomas University in Miami Gardens, Florida, the researchers designed a software algorithm that works with digital ultrasound technology. Ultrasound images are converted into 3D images on a computer screen. In a simulated surgical procedure, the investigators studied the use of augmented-reality technology to fuse real-world and virtual 3D images. These augmented-reality images can then be transmitted to high-definition 3D glasses or other devices. When the surgeon wears such glasses, he or she sees a superimposed, reconstructed 3D digital image over the actual tumor.

"It gives the impression of X-ray vision. You can see the tumor through the skin," says lead author Segundo J. Gonzalez, MD, a surgical oncology fellow at H. Lee Moffitt Cancer Center.

He and his coinvestigators analyzed 66 ultrasound images of tumors (32 pictures of a single tumor and 34 of multiple tumors) inside a plastic model of a breast to determine the augmented-reality system's accuracy of measuring tumor volume. The closer the 3D ultrasound image overlapped with the actual tumor, the more accurate the software was. For detecting a single tumor, the volumetric accuracy was 1.2 cubic millimeters. which Gonzalez called "extremely accurate."