Keyhole surgeries become mcreasingly important in clinical daily routine as they help minimizing the damage of a patient's healthy tissue.The planning of keyhole surgeries is based on medical imaging and an import...Keyhole surgeries become mcreasingly important in clinical daily routine as they help minimizing the damage of a patient's healthy tissue.The planning of keyhole surgeries is based on medical imaging and an important factor that influences the surgeries*success.Due to the image reconstruction process,medical image data contains uncertainty that exacerbates the planning of a keyhole surgery.In this paper we present a visual workflow that helps clinicians to examine and compare different surgery paths as well as visualizing the patientsJ affected tissue.The analysis is based on the concept of hierarchical image semantics,that segment the underlying image data with respect to the input images'uncertainty and the users understanding of tissue composition.Users can define arbitrary surgery paths that they need to investigate further.The defined paths can be queried by a rating function to identify paths that fulfill user-defined properties.The workflow allows a visual inspection of the affected tissues and its substructures.Therefore,the workflow includes a linked view system indicating the three-dimensional location of selected surgery paths as well as how these paths affect the patients tissue.To show the effectiveness of the presented approach,we applied it to the planning of a keyhole surgery of a brain tumor removal and a kneecap surgery.展开更多
Precision liver surgery has advanced significantly with the improvements of technology,and led to a significant decrease in mortality and complication rates.We argued for the necessity of a paradigm shift in liver sur...Precision liver surgery has advanced significantly with the improvements of technology,and led to a significant decrease in mortality and complication rates.We argued for the necessity of a paradigm shift in liver surgery,and advocated“precision liver resection”as a surgical concept for the first time in 2006.The aim of precision liver surgery involves personalized surgery planning based on individual patient status.The core of the precision liver surgery is to be visualizable,quantifiable,and controllable also known as three essential elements.Since precision paradigm is essential in modern surgery,characterized by multi-objective optimization accommodating therapeutic effectiveness,surgical safety,and minimal invasiveness,it had expanded to different surgery,such as neurosurgery and gastrointestinal surgery.Techniques such as three-dimensional(3D)reconstruction,intraoperative navigation systems,and indocyanine green(ICG)fluorescence imaging facilitate precise identification and removal of liver tumors while preserving healthy liver tissue.These advancements not only promote the certainty,predictability,and controllability in surgical practice,and achieve the balance of these three essential elements.As technological progress continues,precision liver surgery holds the promise of safer and more effective treatments.Precision medicine aims to balance operative risk against survival benefit by removing targeted lesions,protecting liver function,minimizing surgical trauma.The ultimate aim of precision medicine is the maximization of patient benefit(Fig.1).展开更多
Background:Myxofibrosarcoma(MFS),especially radiation-Induced MFS(RIMFS)in the head and neck,is an extremely rare malignant fibroblastic tumor.The diagnosis and treatment of MFS remain great challenges.In the present ...Background:Myxofibrosarcoma(MFS),especially radiation-Induced MFS(RIMFS)in the head and neck,is an extremely rare malignant fibroblastic tumor.The diagnosis and treatment of MFS remain great challenges.In the present study,we presented one case of RIMFS.Combined with previous literature,the clinical features,essentials of diagnosis,and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity.Case presentation:We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006.A total tumor resection was performed with preservation of the overlying scalp the underlying bone,and no adjuvant therapy was administered after the first operation.The postoperative pathological diagnosis was high-grade MFS.The tumor relapsed 6 months later,and then,a planned extensive resection with negative surgical margins was carried out,followed by radiotherapy.No relapse occurred in a 12-month postoperative follow-up.Conclusions:Planned gross total resection(GTR)with negative margins is the reasonable choice and footstone of other treatments for MFS.Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck,so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.展开更多
基金This research was funded by the German Research Foundation(DFG)within the IRTG 2057"Physical Modeling for Virtual Manufacturing Systems and Processes”.
文摘Keyhole surgeries become mcreasingly important in clinical daily routine as they help minimizing the damage of a patient's healthy tissue.The planning of keyhole surgeries is based on medical imaging and an important factor that influences the surgeries*success.Due to the image reconstruction process,medical image data contains uncertainty that exacerbates the planning of a keyhole surgery.In this paper we present a visual workflow that helps clinicians to examine and compare different surgery paths as well as visualizing the patientsJ affected tissue.The analysis is based on the concept of hierarchical image semantics,that segment the underlying image data with respect to the input images'uncertainty and the users understanding of tissue composition.Users can define arbitrary surgery paths that they need to investigate further.The defined paths can be queried by a rating function to identify paths that fulfill user-defined properties.The workflow allows a visual inspection of the affected tissues and its substructures.Therefore,the workflow includes a linked view system indicating the three-dimensional location of selected surgery paths as well as how these paths affect the patients tissue.To show the effectiveness of the presented approach,we applied it to the planning of a keyhole surgery of a brain tumor removal and a kneecap surgery.
基金supported by the Beijing Research Ward Excellence Program,BRWEP(BRWEP2024W032240108 for Wang S)National Natural Science Foundation of China(No.81972726 and 82273074 for Yang T+2 种基金No.81930119,No.82090050,and No.82090053 for Dong J)Shanghai Health and Hygiene Discipline Leader Project(No.2022XD001 for Yang T)Shanghai Outstanding Academic Leader Program(No.23XD1424900 for Yang T).
文摘Precision liver surgery has advanced significantly with the improvements of technology,and led to a significant decrease in mortality and complication rates.We argued for the necessity of a paradigm shift in liver surgery,and advocated“precision liver resection”as a surgical concept for the first time in 2006.The aim of precision liver surgery involves personalized surgery planning based on individual patient status.The core of the precision liver surgery is to be visualizable,quantifiable,and controllable also known as three essential elements.Since precision paradigm is essential in modern surgery,characterized by multi-objective optimization accommodating therapeutic effectiveness,surgical safety,and minimal invasiveness,it had expanded to different surgery,such as neurosurgery and gastrointestinal surgery.Techniques such as three-dimensional(3D)reconstruction,intraoperative navigation systems,and indocyanine green(ICG)fluorescence imaging facilitate precise identification and removal of liver tumors while preserving healthy liver tissue.These advancements not only promote the certainty,predictability,and controllability in surgical practice,and achieve the balance of these three essential elements.As technological progress continues,precision liver surgery holds the promise of safer and more effective treatments.Precision medicine aims to balance operative risk against survival benefit by removing targeted lesions,protecting liver function,minimizing surgical trauma.The ultimate aim of precision medicine is the maximization of patient benefit(Fig.1).
文摘Background:Myxofibrosarcoma(MFS),especially radiation-Induced MFS(RIMFS)in the head and neck,is an extremely rare malignant fibroblastic tumor.The diagnosis and treatment of MFS remain great challenges.In the present study,we presented one case of RIMFS.Combined with previous literature,the clinical features,essentials of diagnosis,and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity.Case presentation:We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006.A total tumor resection was performed with preservation of the overlying scalp the underlying bone,and no adjuvant therapy was administered after the first operation.The postoperative pathological diagnosis was high-grade MFS.The tumor relapsed 6 months later,and then,a planned extensive resection with negative surgical margins was carried out,followed by radiotherapy.No relapse occurred in a 12-month postoperative follow-up.Conclusions:Planned gross total resection(GTR)with negative margins is the reasonable choice and footstone of other treatments for MFS.Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck,so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.
