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SIR 2025

Interventional Oncology

Scientific Session

Session: Interventional Oncology 2

Initial investigation of a Fully Integrated Optical Navigation (FIONa) system-based ultrasound (US) to CT image fusion pipeline for delivering precision therapy in interventional oncology

Monday, March 31, 2025
3:27 PM – 3:36 PM CT
Location: Music City Center, 209 ABC
Purpose: To evaluate the applicability of Fully Integrated Optical Navigation (FIONa) system-based ultrasound (US) to CT image fusion towards the development of an integrated multimodality platform for delivering precision therapy in interventional oncology

Materials and Methods: Ultrasound to CT image fusion was performed using a FIONa prototype system consisting of an optical tracking system mounted on a CT gantry (Somatom Definition Edge 128 slice, Siemens Healthineers, Germany), a tracked ultrasound probe (Sequoia US, Siemens Healthineers, USA) fitted with optical markers, and a prototypical software platform that uses inherent registration method to match CT to US imaging coordinate system. Routine clinical CT scan was obtained and sent to FIONa workstation, followed by marking of desired target areas on CT and real-time scanning using the ultrasound system. A liver phantom consisting of tumors and vessels was used to evaluate the performance of the fusion pipeline by measuring the distance between corresponding points on both images and the voxel overlap through the dice coefficient. Further validation was performed in 5 tumor-bearing rats, where the precise alignment of CT and US images was qualitatively assessed through visual comparison between fused CT image and real-time ultrasound imaging with FIONa.

Results: Phantom experiments demonstrated a mean alignment accuracy of 1.54 ± 0.52 mm (min: 0.65 mm and max: 2.84 mm) between US and CT images, as measured by corresponding landmarks in both imaging modalities. The Dice coefficient indicated a mean overlap of 0.95 for the kidney, 0.87 for blood vessels, and 0.79 ±0.03 for tumors. The real-time fusion of US and CT images using FIONa was validated in a preclinical rat model of HCC, achieving a successful co-registration on all 5 rats imaged. Qualitative intraprocedural assessment confirmed the accurate localization of the ultrasound probe on target areas as evidenced by the overlap of kidneys, liver, and tumors in both imaging modalities.

Conclusion: FIONa-based US-CT fusion demonstrated high accuracy in the registration method as well as tracking various anatomical structures throughout the procedure without imposing additional requirements on the operator. This system holds significant potential as an integrated platform that leverages complementary multimodal clinical information to deliver precisely targeted therapy to distinct tumor regions and assessing intraprocedural treatment endpoints.