TITLE:
Image Processing Tool Promoting Decision-Making in Liver Surgery of Patients with Chronic Kidney Disease
AUTHORS:
Kristina Bliznakova, Nikola Kolev, Zhivko Bliznakov, Ivan Buliev, Anton Tonev, Elitsa Encheva, Krasimir Ivanov
KEYWORDS:
Non-Contrast Enhanced Computed Tomography Images; Evaluation of the Residual Function of the Liver; Liver Segmentation; Seeded Regional Growing Algorithm; Virtual Tumor Resection, Decision-Making; Educational Tool
JOURNAL NAME:
Journal of Software Engineering and Applications,
Vol.7 No.2,
February
25,
2014
ABSTRACT: Preoperative assessment of the liver volume and function
of the remnant liver is a mandatory prerequisite before performing major hepatectomy.
The aim of this work is to develop and test a software application for evaluation
of the residual function of the liver prior to the intervention of the surgeons.
For this purpose, a complete software platform consisting of three basic modules:
liver volume segmentation, visualization, and virtual cutting, was developed and
tested. Liver volume segmentation is based on a patient examination
with non-contrast abdominal Computed Tomography (CT). The basis of the segmentation
is a multiple seeded region growing algorithm adapted for use with CT images without
contrast-enhancement. Virtual tumor resection is performed interactively by outlining
the liver region on the CT images. The software application then processes the results
to produce a three-dimensional (3D) image of the “resected” region. Finally,
3D rendering module provides possibility for easy and fast interpretation of the
segmentation results. The visual outputs are accompanied with quantitative measures
that further provide estimation of the residual liver function and based on them
the surgeons could make a better decision.
The developed system was tested and verified with twenty abdominal CT patient sets
consisting of different numbers of tomographic
images. Volumes, obtained by manual
tracing of two surgeon experts, showed a mean relative
difference of 4.5%. The application was used in a study that demonstrates the need
and the added value of such a tool in practice and in education.